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.