Thinking Outside the Checkbox

J Hosp Med. 2018 Feb 1;13(2):100-104. doi: 10.12788/jhm.2859. Epub 2017 Oct 18.

Abstract

A 34-year-old, previously healthy Japanese man developed a dry cough. He did not have dyspnea, nasal discharge, sore throat, facial pain, nasal congestion, or postnasal drip. His symptoms persisted despite several courses of antibiotics (from different physicians), including clarithromycin, minocycline, and levofl oxacin. A chest x-ray after 2 months of symptoms and a noncontrast chest computed tomography (CT) after 4 months of symptoms were normal, and bacterial and mycobacterial sputum cultures were sterile. Treatment with salmeterol and fl uticasone was ineffective.

MeSH terms

  • Adult
  • Behcet Syndrome / diagnostic imaging*
  • Cough* / etiology
  • Deglutition Disorders / diagnosis*
  • Fever* / etiology
  • Humans
  • Male
  • Positron Emission Tomography Computed Tomography / methods