Abstract
The patient is a 47-year-old woman with chronic sinusitis, allergic rhinitis, atopic dermatitis, and gastroesophageal reflux disease who was referred for worsening respiratory symptoms and a new pulmonary lesion. She had a history of asthma since age 19 years and quit smoking after 23 pack-years. In recent years, worsening respiratory symptoms necessitated increased asthma medications. Over the past year, she also began to note systemic symptoms, including fatigue, fever, chills, night sweats, abdominal pain, intermittent nonpruritic rash on thighs and buttocks, mild bilateral thigh pain, and bilateral hand numbness.
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