01455nam a2200289   4500001000800000005001700008007000300025008004100028040000800069041000800077100003200085245007100117300002300188520062300211650002300834650001700857650002900874650002400903650000300927650001500930700003000945700002200975700002100997700002001018700002401038773010301062ESSALUD20260804152234.0ta      t        pe ||||| |||| 00| 0 spa d  aBMG  aeng  aGoldberg, Hilary J. eAutor  aCase 19-2026: A 68-year-old man with fatigue, fever, and hypoxemia  apáginas: 176-185  aA 68-year-old man was evaluated in an outpatient clinic of this hospital because of fatigue and dyspnea. The patient had a history of chronic obstructive pulmonary disease with progressive bronchitis symptoms that had resulted in frequent emergency department visits and hospital admissions, as well as the use of supplemental oxygen during exertion. Three years before the current presentation, bronchoscopic lung-volume reduction surgery was performed, with placement of four endobronchial valves. One year later, symptoms progressed, and the patient was referred to the lung transplantation center of this hospital.  aMEDICINA CLÍNICA  aNEUMOLOGÍA  aENFERMEDADES INFECCIONES  aCUIDADOS INTENSIVOS    aTRASPLANTE  aNandakumar, Harikrishnan   aKeller, Brian C.   aHariri, Lida P.   aKim, Arthur Y.   aCastillo, Briana N.0 022717dMassachusetts NEJM GroupoNEJM002tThe New England Journal of Medicine wESSALUDx0028-4793