Dry cough in a middle-aged man

Cough is often a distressing feature and may be caused due to varied reasons. A 39-year-old man presented with complaints of cough and had significant pigeon exposure. His chest X-ray revealed mediastinal enlargement and computed tomography chest revealed air trapping and mediastinal lymphadenopathy. Both endobronchial and transbronchial biopsies revealed granulomas. Thus, the patient was diagnosed as a case of sarcoidosis and started on steroids. Hypersensitivity pneumonitis may often mimic sarcoidosis; however, the presence of endobronchial granulomas will diagnose the latter condition.