Long-term cough hints at diagnosis
A 24-year-old female non-smoker presents with several months of exertional dyspnoea and a productive cough.
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<p>A 24-year-old female non-smoker presents with several months of exertional dyspnoea and a productive cough.</p><p>Bronchodilators and inhaled corticosteroids have not helped.</p><p>Her weight is stable, though BMI has always been low at 18kg/m<sup>2</sup>.</p><p>She has no fever, night sweats, risk factors for TB or gastrointestinal symptoms. Examination is unremarkable.</p><p>Spirometry reveals an irreversible obstructive pattern.</p><p>Pathology is normal, including blood count, inflammatory markers, sweat chloride test, <em>Mycobacterium tuberculosis</em>interferon gamma release assay and aspergillus antibodies.</p><p>Sputum cultures <em>Psuedomonas aureginosa</em>.</p><p>Chest CT (pictured) reveals upper lobe predominant bronchiectasis (arrows) and mucoid impaction (arrowheads).</p>
Dr Kate Kelso is Medical Co-editor at Australian Doctor and a GP in Sydney, NSW.
