In August, a 24-year-old man from Virginia developed difficulty breathing and bilateral lobe infiltrates 2 months after driving through California. During initial evaluation, typical pneumonia was suspected, and he was treated with antibiotics. Efforts to diagnosis the pneumonia were unsuccessful. In October, a laryngeal mass was detected, and laryngeal cancer was suspected; treatment with steroids and bronchodilators did not result in improvement. Lung biopsy and laryngoscopy detected diffuse granular tissue. He was treated with amphotericin B and discharged after 5 days. What was the disease?
What might have been done differently to decrease the patient’s recovery time from 3 months to one week?

A41-year-old man comes to the clinic complaining of a chronic cough over the past 4 months, which has now been accompanied by haemoptysis. he denies smoking or any past medical history. on physical examination, his head and neck examination is normal. his lungs have diffuse bilateral rales. cardiac examination is normal. laboratory findings reveal na 142 meq/l, k 4.2 meq/l, cl 110 meq/l, hco3 24 meq/l, bun (blood urea nitrogen) 39 mg/dl, creatinine 2.9 mg/dl. urinalysis reveals microscopic haematuria and 4+ proteinuria. which of the following serologic blood tests would most confirm the suspected diagnosis? - anti-glomerular basement membrane antibodies- anti-mitochondrial antibodies- anti-neutrophilic antibodies- anti-parietal cell antibodies- anti-smooth muscle antibodies