The Pulm PEEPs are excited to bring our first mystery case! Kristina Montemayor and Dave Furfaro hear a fascinating case presentation from Pulm PEEPs senior editor Ansa Razzaq. Join us as we work through this case together to come to a diagnosis, and share our thought process along the way. Come back to these show notes afterward, or once you’ve solved the case yourself, for some key teaching pearls and representative images.

Patient Presentation

A 66-year-old woman with no smoking history and past medical history of previously well-controlled asthma is referred to pulmonary clinic after multiple recent episodes of dyspnea, wheezing, and coughing. The episodes have features consistent with asthma exacerbations; however, they are also associated with migratory infiltrates. She has been treated with multiple courses of antibiotics and steroids, and despite escalating therapy, the episodes are occurring more frequently and she was worsening overall exercise tolerance. Listen in to hear more and try to solve the case!

Key Learning Points

**Spoilers Ahead** If you want to think through the case on your own we advise listening to the episode first before looking at the infographics below.

Images from Asthma NAE and PP Third Expert Panel on the Diagnosis and Management of. *Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma*. National Heart, Lung, and Blood Institute (US); 2007.

Image from Asthma NAE and PP Third Expert Panel on the Diagnosis and Management of. *Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma*. National Heart, Lung, and Blood Institute (US); 2007.

References and links for further reading

3. A Case of Worsening Episodic Dyspnea

PulmPEEPs

3. A Case of Worsening Episodic Dyspnea