Every Patient with Chronic Cough Should be Evaluated Cautiously

Md. Naimul Hoque1, Bashir Ahmed1, Rahat Ara Nur2, SM Lutfor Rahman3

Abstract:
A 52 years old gentleman presented with chronic cough in early part of 2013.
Initially the cough was dry for more than one and half year with no history of
shortness of breathing, wheezes haemoptysis or chest pain and was treated
symptomatically. But his cough reappeared after an interval of 10 months along
with shortness of breath and scanty sputum production and his blood
examination reports showed high ESR, chest X-ray revealed bilateral scattered
ill defined opacities and was treated with Cat-I ATT (Anti Tubercular Therapy).
His condition was deteriorating and was referred in our institute. On chest
examination he was found scattered fine crepitations on both lung fields. MT
test was found no iduration (00 mm) after 72 hours but raised serum Calcium
and ACE (Angeotensin Converting Enzyme) level and BAL (Bronchoalveolar
Lavage) fluid cytology revealed lymphocytosis but no fungal hyphae or any
gram stained bacteria was found. Based on clinical findings and investigations
our final diagnosis was Sarcoidosis, and he was treated with corticosteroid
and immunosuppressant. His condition was improved and pulmonary lesions
disappeared within a few months.

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