Acute Onset Of Dyspnea With Wheezing And Cough

A 35-year-old male without significant past medical history, was transferred for evaluation of acute onset of dyspnea (< 48 hours), wheezing and a cough productive of blood-tinged sputum. PMH: The patient denied a personal or family history of pulmonary disease. He was previously able to participate in athletic events without symptoms. He denied the use of tobacco, alcohol or drugs. He was employed as an industrial insulation application specialist.

Approximately one day prior to presentation, he admitted to an unprotected exposure to a maleic anhydride gas cloud (used as a resin in fiberglass insulation). The patient denied any history of previous exposures. At the time of presentation, the patient did not have a fever or chills and did not report recent weight gain or lower extremity swelling. He had no chest pain, but did complain of chest tightness. He denied nausea, vomiting,…