• Zein Kattih, Akhilesh Mahajan, Brian Birnbaum, Abdulrahman Aman, Richard S Lazzaro, and Bushra Mina.
• Department of Internal Medicine, Lenox Hill Hospital, New York, NY. Electronic address: zkattih@northwell.edu.
• Chest. 2021 Apr 1; 159 (4): e221-e224.

Case PresentationA 54-year-old man sought treatment at the ED for a productive cough with green phlegm of approximately 6 months' duration that was accompanied by a 10-pound weight loss, night sweats, and occasional subjective fevers. He had made several prior visits to the ED for the cough and was hospitalized 4 months earlier for similar symptoms, at which time he underwent a bronchoscopy with BAL and was discharged with antibiotics for presumed pneumonia. He did not report any itching, rashes, sinus infections, joint swelling, joint pain, or GI symptoms. His long-term medications included omeprazole and amlodipine. The patient had a past medical history of grade III follicular lymphoma for which he completed six cycles of bendamustine 4 years before presentation and had been in remission since. He was a never smoker, had a recent travel history to the Dominican Republic 8 months before admission, and had no recent sick contacts.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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