CASE STUDY:
34-Year-Old White Male With Progressive Dyspnea and Cough
for About 1 Year

CLINICAL INFORMATION

CHIEF COMPLAINT

Progressive dyspnea and cough for about 1 year.

HISTORY OF PRESENT ILLNESS

A 34-year-old white male with no significant medical history initially evaluated nine months before current visit for progressive dyspnea and cough for about 1 year. Patient described a dry cough with intermittent episodes of a persistent cough, which affected his ability to talk. During the same time period he had experienced a slowly progressive dyspnea that limited his physical activities at work and home. Patient denied fever, hemoptysis, wheezing, pleuritic chest pain, orthopnea, paroxysmal nocturnal dyspnea, joint pain, skin rashes, or weight loss.

ADDITIONAL DATA

Physical examination:
BP: 129/80 mm Hg
HR: 77 bpm
RR: 18 bpm
Saturation: 100%
No evidence of clubbing, no lymphadenopathy
LUNGS: Clear to auscultation, decreased breath sounds both bases, no wheezing, no crackles or rhonchi
HEART: S1 and S2 normal, no murmurs or gallop
ABDOMEN: Bowel sounds positive, no abdominal pain or organomegaly
LOWER EXTREMITIES: No edema

Social History: Patient is life-long nonsmoker, has no pets, and works as a machinist (16 years) with silica exposure and grinding heavy metals.