Recurrent high-altitude illness associated with right pulmonary artery occlusion from granulomatous mediastinitis.

While travelling across the intermountain West at an altitude of approximately 2,300 m, a 35-year-old man developed symptoms of HAPE. Delay in diagnosis and treatment was nearly lethal. Subsequent evaluation demonstrated unilateral pulmonary artery occlusion, presumably resulting from antecedent granulomatous mediastinitis. This case report supports the concept of evaluating anyone developing HAPE at relatively low altitude for an underlying predisposition.