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Dry cough in a middle-aged man.

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Summary

A patient with cough and pigeon exposure was diagnosed with sarcoidosis. Endobronchial granulomas confirmed the diagnosis, differentiating it from hypersensitivity pneumonitis.

Keywords:
Coughhypersensitivity pneumonitissarcoidosis

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Area of Science:

  • Pulmonology
  • Immunology
  • Radiology

Background:

  • Cough is a common symptom with diverse etiologies.
  • Pigeon exposure can be linked to respiratory conditions.
  • Mediastinal lymphadenopathy and air trapping are key radiological findings.

Purpose of the Study:

  • To present a case of sarcoidosis.
  • To highlight the diagnostic challenges in differentiating sarcoidosis from hypersensitivity pneumonitis.
  • To emphasize the role of biopsy in diagnosis.

Main Methods:

  • Clinical presentation of a 39-year-old male with cough and significant pigeon exposure.
  • Imaging studies including chest X-ray and computed tomography (CT) chest.
  • Histopathological examination of endobronchial and transbronchial biopsies.

Main Results:

  • Chest X-ray showed mediastinal enlargement.
  • CT chest revealed air trapping and mediastinal lymphadenopathy.
  • Biopsies confirmed the presence of granulomas, leading to a sarcoidosis diagnosis.

Conclusions:

  • Sarcoidosis can present with cough and mediastinal lymphadenopathy.
  • Endobronchial granulomas are crucial for diagnosing sarcoidosis.
  • Distinguishing sarcoidosis from hypersensitivity pneumonitis is essential, with biopsy being definitive.