Increased adenosine deaminase activity in Q fever pneumonia with pleural effusion.

Communications to the EdItor son, suggest chest CT.” Prospective studies should address the nurnher ofCT scans being ordered to evaluate lesions that are already established by roentgenogram as benign. It is also alarming to us that a CT scan can precede the Gram stain or tuberculosis smears on patients with infectious histories and new infiltrates. Our colleagues at Dartmouth2 q 5lly aware ofhow the advances in diagnostic imaging are not always the best way to “deal with uncertainty.”’ We hope that Dr. DiMarco important editorial message will hit home before the next ACCP section report on clinical staging ofpatients with nonsmall-cell lung cancer comes to press. Michael F. Tenholder, M.D., Pulmonary Disease Section, VA Medical Center, Augusta, Ga; and Warren L Whitlock, M.D., Pulmonat Division, ELsenhowerAr-my Medical Center, Fort Gordon, Ga