• Ali Khawaja and Robert Kotloff.
• Department of Internal Medicine, Cleveland Clinic, Cleveland, OH. Electronic address: alianwar90@hotmail.com.
• Chest. 2019 Feb 1; 155 (2): e55-e59.

Case PresentationA 31-year-old white man presented for evaluation of productive cough and dyspnea on exertion of 2 months' duration. Associated symptoms included wheezing, chest tightness, and postnasal drip. He was recently treated for pneumonia with a 7-day course of levofloxacin because of an abnormal chest radiograph demonstrating bilateral infiltrates, but his symptoms failed to improve. He had a medical history of mild intermittent asthma and was on no active treatment. He was a nonsmoker. He was born in the United States. He denied any recent travel within or outside the United States, sick contacts, or illicit drug use. He did not have any pets and denied exposure to mold, hot tubs, a down comforter, or pillows. He worked in a vocational program and his hobbies included refinishing wood floors.Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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