A 42-year-old woman was admitted to another hospital because of worsening dyspnea and cough.During the year before admission, the patient had had mild dyspnea on exertion, a cough that was occasionally productive of whitish mucus, slight fatigue, The New England Journal of Medicine Downloaded from nejm.org at DEAKIN UNIVERSITY on August 11, 2015. For personal use only. No other uses without permission.