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Postgraduate Education Corner: PULMONARY AND CRITICAL CARE PEARLS |

A 56-Year-Old Man With Multiple Airway Procedures With Fever, Cough, and Dyspnea

Abhilash Nair, MD; Salam Salman, MD; Joshua Cantor, MD; Paul Marik, MD, FCCP
Author and Funding Information

*From the Department of Pulmonary and Critical Care, Thomas Jefferson University Hospital, Philadelphia, PA.

Correspondence to: Abhilash Nair, MD, Thomas Jefferson University, 834 Walnut St, Suite 650, Philadelphia, PA 19107; e-mail: Abhilash.pochappan@mail.tju.edu


The authors have no conflicts of interest to disclose.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2008;134(6):1332-1335. doi:10.1378/chest.07-2447
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A 56-year-old man was admitted to hospital with a 1-week history of worsening cough and dyspnea on exertion. He also complained of pleuritic chest pain with fever and chills of 2 days in duration. He had a history of chronic cough with clear-to-yellowish sputum turning purulent with infection. His exercise tolerance had been diminishing over the years, currently less than a city block. He had three-pillow orthopnea but no paroxysmal nocturnal dyspnea. He denied any hemoptysis or weight loss. His medical history was significant for COPD and multiple upper airway procedures including a temporary tracheostomy with biopsy (Fig 1) in 1989, and a right upper lobectomy for adenocarcinoma in 1994. He was a 100–pack-year smoker and admitted to occasional cocaine use. Both his father and sister were heavy smokers and had lung cancer.

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