An 84-Year-Old Physician With Progressive Dyspnea and Bilateral Upper Lobe Opacities

Abstract

An 84-year-old physician was seen in the pulmonary clinic with 10days of progressive exertional dyspnea, night sweats, and dry cough. For the past 5months, he had been taking ibuprofen for lumbar radiculopathy from spinal stenosis. Ten days earlier, ibuprofen was switched to naproxen 250mg twice daily because of its longer half-life. He denied fever, weight loss, rash, dysphagia, proximal muscle weakness, wheeze, sinus congestion, and peripheral numbness/tingling. Medical history included paroxysmal atrial fibrillation, hypertension, Hashimoto's thyroiditis, and OSA. Long-term medications included aspirin, flecainide, atorvastatin, amlodipine, levothyroxine, and candesartan. He was a lifelong nonsmoker. There was no history of recent travel.