A 63-year-old man with an extensive smoking history presented with a complaint of persistent dry cough for 3 months. His past medical history was significant for severe COPD with an FEV1 at 40% predicted (stage III by GOLD [Global Initiative for Obstructive Lung Disease] criteria). The patient was retired and a current cigarette smoker, and he had no pets. There was no history of prior malignancy or recent travels. He had no fever, night sweats, or weight loss. He was not receiving any angiotensin-converting enzyme inhibitors. There were no symptoms suggestive of upper airway cough syndrome or gastroesophageal reflux disease.