A Case of Progressively Worsening Dyspnea and Chronic Cough in a Patient With Known Bronchiectasis.

A 53-year-old Black woman was referred to the pulmonary clinic for progressively worsening exertional dyspnea over the past 3 years and a chronic nonproductive cough. She had a history of childhood asthma, with 2 prior hospitalizations, as well as an unspecified nasal surgery 20 years ago. She was diagnosed with bronchiectasis 10 years ago by her primary care physician and was compliant with airway clearance techniques, including nebulized hypertonic (7%) saline and albuterol-ipratropium and a positive expiratory pressure handheld device. Review of systems was positive for fatigue, seasonal allergies, occasional heartburn, and occasional stiffness of the small joints of the hands. She had a family history of asthma in her cousin and sarcoidosis in her father; her mother had a significant smoking history and was deceased from complications of lung cancer. She had no history of occupational exposures, no pets, and no significant travel history.