Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chronic, progressive history of exertional dyspnea and non-productive cough. Significant history of avian exposure (pigeons/parrots/poultry) identified. Symptoms are insidious in onset, associated with fatigue, weight loss, and occasional low-grade fevers. No history of smoking or occupational chemical exposure. Symptoms worsen with increased contact with avian antigens.
Clinical Examination Findings
Vitals: Stable, resting O2 saturation [Value]% on room air. Pulmonary: Bilateral fine end-inspiratory crackles (Velcro-like) noted on auscultation, predominantly in the lower lung fields. No wheezing. Cardiac: Regular rate and rhythm, no murmurs, no signs of right heart failure (no JVD or peripheral edema). Integumentary: No clubbing or cyanosis noted.
Treatment Protocol
1. Strict avoidance of avian antigens (primary intervention). 2. Systemic corticosteroids (e.g., Prednisone) initiated for active inflammation. 3. Consider steroid-sparing agents (e.g., Mycophenolate Mofetil or Azathioprine) for chronic/refractory cases. 4. Pulmonary rehabilitation and supplemental oxygen if resting/exertional hypoxemia is present. 5. Annual influenza and pneumococcal vaccinations.