• Narendra Kumar Narahari, Paramjyothi K Gongati, Shantveer G Uppin, Anu Kapoor, Bhaskar Kakarla, and Ramakrishna Dev Tella.
• Department of Respiratory Medicine, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India. Electronic address: drnarendrajipmer@gmail.com.
• Chest. 2016 Oct 1; 150 (4): e109-e115.

AbstractA 66-year-old man presented with dry cough and shortness of breath on exertion of 6 months' duration. There were no complaints of fever and hemoptysis. His history was significant for recurrent episodes of respiratory tract infections over the previous 4 years. He had also had episodes of recurrent otitis media and pus discharge from the left ear for 3 years, with progressive loss of hearing. There was no history of recurrent skin infections or diarrhea. He was treated symptomatically with antibiotics by local general practitioners. He was a nonsmoker and did not drink alcohol, and there was no history of environmental or occupational exposure. He had been known to have diabetes for 10 years. He had negative results for the presence of HIV and hepatitis B surface antigen.Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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