--- title: "35-year-old man: fever, dyspnea, diffuse reticular opacities | Sutter Health" description: "NSIP should be considered in the differential diagnosis of a patient presenting with the subacute onset of fever, dyspnea, cough, & diffuse reticular opacities." url: "https://www.sutterhealth.org/research/publications/35-yo-man-fever-dyspnea-reticular-oopacities-1055312816" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. 35-year-old man: fever, dyspnea, diffuse reticular opacities # A 35-year-old man with fever, dyspnea, and diffuse reticular opacities. Katikireddy CK, Krishna G, Keifer T, Kuschner W, & Rosen G. _Chest. 129(2):482-7._ 2006-02-01 ## Abstract 1\. NSIP should be considered in the differential diagnosis of a patient presenting with the subacute onset of fever, dyspnea, cough, and diffuse reticular opacities when more common causes, such as infection, have been excluded. 2\. Patients with RA may rarely present with respiratory symptoms due to NSIP-pattern interstitial pneumonia in advance of arthralgias or arthritis. 3\. A histologic pattern of NSIP on a lung biopsy should alert a clinician to investigate thoroughly for underlying etiologic factors such as drug toxicity, occupational and environmental exposures, CTD, and infections including HIV. 4\. NSIP, idiopathic or secondary to CTD, responds well to systemic steroids with a more favorable prognosis as compared with other idiopathic interstitial pneumonias such as UIP. [PubMed abstract](http://journal.publications.chestnet.org/article.aspx?articleid=1084304) ![Ganesh Krishna, M.D., FCCP](https://dyn.mktgcdn.com/p/7HZoN6h0d4phO4VQYcU6TE-_Cn72_cBpIS3NRGru51E/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Ganesh Krishna, M.D., FCCP Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/ganesh-krishna-md-fccp-1049681082) ## Research topics - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Lung Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Lung+Diseases%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Parasitic pulmonary eosinophilia.](https://www.sutterhealth.org/research/publications/parasitic-pulmonary-eosinophilia-1055312949) Chitkara RK, Krishna G. Semin Respir Crit Care Med. 27(2):171-84. 2006 Apr 01 - Publication ### [Endobronchial ultrasound-guided transbronchial needle injection of liposomal amphotericin B for the treatment of symptomatic aspergilloma.](https://www.sutterhealth.org/research/publications/endobrachial-injection-amphotericin-b-aspergilloma-1055312303) Parikh MS, Seeley E, Nguyen-Tran E, Krishna G. J Bronchology Interv Pulmonol. doi: 10.1097/LBR.0000000000000383. \[Epub ahead of print\] 2017 Jun 05 - Publication ### [The dying thoracic patient.](https://www.sutterhealth.org/research/publications/dying-thoracic-patient-1055312967) Krishna G, Raffin TA. Chest Surg Clin N Am. 8(3):723-39. 1998 Aug 01 - Publication ### [Transbronchial Cryobiopsies for the Diagnosis of Diffuse Parenchymal Lung Diseases: Expert Statement from the Cryobiopsy Working Group on Safety and Utility and a Call for Standardization of the Procedure.](https://www.sutterhealth.org/research/publications/transbronchial-cryobx-dx-diffuse-parenchymal-lung-diseases-1055312384) Hetzel J, Maldonado F, Ravaglia C, Wells AU, Colby TV, Tomassetti S, Ryu JH, Fruchter O, Piciucchi S, Dubini A, Cavazza A, Chilosi M, Sverzellati N, Valeyre D, Leduc D, Walsh SLF, Gasparini S, Hetzel M, Hagmeyer L, Haentschel M, Eberhardt R, Darwiche K, Yarmus LB, Torrego A, Krishna G, Shah PL, Annema JT, Herth FJF, Poletti V. Respiration. doi: 10.1159/000484055. \[Epub ahead of print\] 2018 Jan 09 - Publication ### [Update on the treatment of lymphangioleiomyomatosis.](https://www.sutterhealth.org/research/publications/update-treatment-lymphangioleiomyomatosis-1055312862) Krishna G, Berry G, Kao P, Rosen G, Raffin TA. Clin Pulmon Med. 6(2):126-132. 1999 Mar 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/35-yo-man-fever-dyspnea-reticular-oopacities-1055312816#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"35-year-old man: fever, dyspnea, diffuse reticular opacities"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/35-yo-man-fever-dyspnea-reticular-oopacities-1055312816#medicalscholarlyarticle","name":"A 35-year-old man with fever, dyspnea, and diffuse reticular opacities.","headline":"35-year-old man: fever, dyspnea, diffuse reticular opacities","abstract":"1. NSIP should be considered in the differential diagnosis of a patient presenting with the subacute onset of fever, dyspnea, cough, and diffuse reticular opacities when more common causes, such as infection, have been excluded. 2. Patients with RA may rarely present with respiratory symptoms due to NSIP-pattern interstitial pneumonia in advance of arthralgias or arthritis. 3. A histologic pattern of NSIP on a lung biopsy should alert a clinician to investigate thoroughly for underlying etiologic factors such as drug toxicity, occupational and environmental exposures, CTD, and infections including HIV. 4. 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