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Chronic cough in Swiss bagpipe player
  1. Valeria Schindler1,
  2. Christoph Gubler1,
  3. Alexander Turk2,
  4. Anton S Becker3,
  5. Daniel Pohl1
  1. 1 Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
  2. 2 Department of Internal Medicine, See-Spital Horgen, Horgen, Switzerland
  3. 3 Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
  1. Correspondence to Dr Valeria Schindler, Division of Gastroenterology and Hepatology, University Hospital Zurich, Raemistrasse 100 8091, Zurich, Switzerland; valeria.schindler{at}usz.ch

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Introduction

A 34-year-old man presented to our GI clinic with chronic cough. Coughing episodes exacerbated on days of bagpipe playing and the morning after. Methacholine testing revealed airway hyperreactivity. Allergic bronchopulmonary aspergillosis could be excluded; CT scan of the chest was without pathological findings. Also bronchoscopy with bronchoalveolar lavage (BAL) and mucosal biopsy failed to reveal a pulmonary aetiology of the cough. Minor findings in BAL were an elevated number of macrophages and bacteria representative of the oral flora. A trial with inhalative budesonide and formoterol and consecutively 8 weeks of proton pump inhibitor …

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