Dry cough and dyspnoea rapidly increasing to respiratory failure in a male smoker.

CASE HISTORY A 65-yr-old male, current smoker of .30 cigarettes?day (total smoking history 150 pack-yrs), who was working as a bus driver, presented at the Evangelismos Hospital (Athens, Greece) complaining of increasing breathlessness on exertion and dry cough during the past 2 months. He had no animal exposure and he hadn’t travelled abroad during the last few years. His medical history showed arterial hypertension, for which he was receiving treatment with an angiotension-converting enzymeinhibitor (ramipril) plus hydrochlorothiazide, as well as asymptomatic cholelithiasis and prostate hypertrophy for which he was receiving tamsulosin hydrochloride. He did not mention suffering from fever in the last few months.