Smoking related lung changes
Fevers with increasing shortness of breath. Heavy cigarette and marijuana usage. Fungi isolated from sputum.
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In the medial basal segment of the left lower lobe, there is a 5 mm nodule adjacent to the pleura, which is stable. There is a background of severe bullous emphysema, particularly in the apices. Linear atelectasis is present within the left lung base in particular. There is no lymphadenopathy above the diaphragm. Malunited right posterior fifth rib fracture, new since previous CT. No destructive bone lesion.