A 55-year-old male diplomat had been making frequent long-distance flights from Narita (Japan) to the Middle East or the African Continent over a period of 2 years. Each one-way trip took at least 24 h. After one trip (April 2010), the patient noticed that he had developed a dry cough. At the beginning of July 2010, he flew to Kuwait via Paris and Amsterdam, a journey of 34 h. During the patient’s 3-night stay in Kuwait, his cough was exacerbated. He subsequently flew to Algeria via Lebanon and Paris overnight. At the time, Algeria was experiencing a heat wave and the patient developed dyspnea on exertion. By the time the patient was on his way home, 9 days after his initial departure, he could not walk without resting frequently. After returning to Japan, he experienced coughing fits every 15 min. He was admitted to hospital 3 days after his return. The patient was a non-smoker, but his body mass index was 31.8 kg/m
2. The patient’s blood pressure upon arrival in the Emergency Room...
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