Silicosis in the Setting of Chronic Granite Exposure: A Case Report

Silicosis develops when inhaled silica particles reach the alveoli, causing interstitial lung disease. We present the case of a 50-year-old male with no known past medical history who arrived at the emergency department with a 10-month history of dyspnea, which had worsened over the past four days. He reported working in a granite factory for 18 years, consistently wearing a mask while cutting and grinding stone. Initial laboratory tests were unremarkable. A viral respiratory panel and acid-fast bacilli cultures and smears (repeated three times) were all negative, lowering the suspicion for tuberculosis. Antifungal testing was also negative, except for a positive <i>Histoplasma</i> antibody; however, the urine <i>Histoplasma</i> antigen was negative. Bronchoalveolar lavage revealed an unremarkable cell differential, and respiratory cultures were negative. Given the negative infectious workup, along with the radiographic findings and occupational history, the patient's presentation was most consistent with silicosis.