A 35-Year-Old Man with Chronic Cough and Worsening Dyspnea

Abstract

Morning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case. This report examines the case of a 35-year-old man who presented to the emergency department with cough and dyspnea on exertion. The cough began 2 years prior and has persisted despite multiple treatment courses of antibiotics. He began to feel dyspneic 1 year ago; it has progressively worsened, and he now has difficulty climbing up a flight of stairs. Using questions, physical examination, and testing, an illness script for the presentation emerges. As the clinical course progresses, the differential is refined until a diagnosis is made.