Case description
A 40-year-old male, a stone crusher for the past 10 years, presented to
the emergency department with a complaint of shortness of breath at rest
for 4 hours. He also presented with an exaggeration of cough for about
10 years which increased progressively for the past nine months. There
was no history of fever, night sweats, anorexia, weight loss, joint
pain, or skin rashes. He did not report any chest pain and hemoptysis.
Notably, the individual had been clinically diagnosed with active TB
based on X-ray abnormalities and clinical findings and had a full course
of TB treatment. There was no history of smoking and alcohol
consumption. On examination, the patient was with a modified medical
research council (MMRC) dyspnea scale of 4, a blood pressure of 130/95
mmHg, a rapid pulse rate of 140 bpm, respiratory rate of 30 breaths per
min, temperature of 98.6 degrees F and an oxygen saturation level of
83% without supplemental oxygen. On the chest, examination revealed
tracheal deviation towards the right, accompanied by diminished
vesicular breath sounds and diffuse crepitations. The patient was
admitted with a provisional diagnosis of silicosis based on clinical
examinations and a chest X-ray.