Dr. Louis Phillip Mattoso: This is the chest x-ray film of a 31-year-old white housewife who entered the hospital after the acute onset of shortness of breath (Fig 1). She had a slight fever.
Dr. Henry P. Pendergrass: Does she have an "occupational history"?
Dr. Mattoso: There was none.
Dr. Pendergrass: The roentgenogram shows a very impressive, diffuse miliary infiltrate throughout both lung fields. Something you must consider is miliary tuberculosis. Alveolar proteinosis is another possibility. It could be almost any type of pneumoconiosis, but we don't have an occupational history. Housewives can get acute beryllium disease from washing their husband's work clothes.
Dr. Paul F. J. New: Were there any birds around her home?
Dr. Mattoso: No, there were not.
Dr. Stanley P. Bohrer: Could this be the interstitial pneumonia of acute rheumatic fever or the pneumonia associated with viral infections?
Dr. Alfred L. Weber: Chickenpox pneumonia can look