-year-old white woman with a medical history significant for
hypothyroidism, hypertension, and coronary artery disease was referred
for evaluation of recurrent productive cough, fever, and wheezing.
During the prior 5 years, she had experienced similar episodes of
respiratory illness, for which she had received 7 to 14 days of oral
antibiotics and inhaled bronchodilators. In the last year,
her symptoms have been associated with progressive dyspnea,
and recurrent bouts of nonbloody diarrhea. She denied any
hemoptysis, orthopnea, or paroxysmal nocturnal dyspnea.