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13329 Medicine

A 48-year-old man presents with 3 weeks of fever, fatigue, and shortness of breath. He has a history of “nasal allergies” and asthma, which have been poorly controlled in the past month. Two days prior to presentation, he developed weakness in his left foot and it now “drags” when he walks. On examination, his blood pressure is 165/90 mm Hg, pulse 100/min, respirations 20/min, and lungs have bilateral expiratory wheezes. There is left foot drop, and the rest of the neurologic examination is normal. Laboratory evaluation reveals ESR of 90 mm/h, WBC of 14,000/mL with 10% eosinophils, and 1+ proteinuria. A CXR shows bilateral pulmonary infiltrates.For the above patient with vasculitis syndrome, select the most likely diagnosis.

Apolyarteritis nodosa (PAN)
BChurg-Strauss disease
CHenoch-Schonlein purpura
Dvasculitis associated with infectious diseases
Medicine
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