CASE STUDY:
65-Year-Old Male with 6 Weeks of Progressive Dyspnea on Exertion

CLINICAL INFORMATION

HISTORY OF PRESENT ILLNESS

A 65-year-old male without a history of underlying lung disease presented with progressive dyspnea on exertion over 6 weeks. The patient was in his normal state of good health and active prior to the onset of his shortness of breath. He denied the presence of joint pain, skin lesions, myalgias, or any systemic symptoms like fever, fatigue, or generalized malaise that would suggest a connective tissue disease.

PAST MEDICAL HISTORY

The patient's past medical history was unremarkable. He was taking no medications associated with interstitial lung disease and had no drug allergies.

SOCIAL HISTORY

The patient was a former smoker, and he denied any occupational exposures or bird exposures.

FAMILY HISTORY

The patient denied the presence of any interstitial lung diseases or connective tissue diseases in his immediate family members.

PHYSICAL EXAMINATION

On examination, the patient was a pleasant male, appearing his stated age and in no acute distress. His vital signs are listed below:

Examination of his head and neck was unremarkable. Auscultation of his chest revealed bibasilar and axillary crackles. His heart had a regular rate and rhythm without murmurs, rubs, or gallops, and his abdomen was benign. He had no cyanosis, clubbing, or edema of the extremities.

LABORATORY AND SEROLOGIC TESTING

HIGH-RESOLUTION COMPUTED TOMOGRAPHY

A high-resolution computed tomography (HRCT) scan with 2 mm cuts of the lung fields demonstrated peripheral honeycomb changes and traction bronchiectasis, most prominent in the lower lung zones.