Clinical History.—A boy, 12 years 7 months old, was brought to Medical Associates Medical Center, Chelmsford, Mass, on Oct 18, 1977. He had been referred by his schoolroom teacher because of a chronic brassy cough that was disruptive to the classroom. It is noted that he was otherwise asymptomatic. He showed no dyspnea, no shortness of breath, and although slightly obese, was able to participate fully in the school physical education program and after-school activities with his peers. His medical history was as follows: birth weight, 3,480 g; benign neonatal period with no episodes of respiratory distress; no history of recurrent respiratory infection; and no previous hospitalizations.
Physical Examination.—His weight was at the 60th percentile and his height was at the 40th percentile. He was acyanotic. There was no clubbing of the nails and he was not tachypneic. He did exhibit a brassy, nonproductive irritating cough throughout the examination.