Prolonged Suppression of Cough After Inhalation of Lidocaine in a Patient With Sarcoid

CHRONIC persistent cough can present both difficult diagnostic and therapeutic problems. Recent studies have primarily addressed the diagnostic evaluation of chronic cough, and these studies suggest that adequate treatment of the cause is highly effective in suppressing the cough.1,2In some patients, however, chronic cough may be caused by pulmonary disease that is unresponsive to therapy. Indeed, chronic cough may be more disabling than any other pulmonary symptom, such as dyspnea, and suppression of the cough then becomes a major therapeutic goal. We describe a patient with sarcoid with disabling cough who had an inadequate response to codeine, but who has had prolonged suppression of his cough after inhalation of nebulized lidocaine. Report of a Case A 34-year-old man was diagnosed as having pulmonary sarcoid in 1976 by chest roentgenogram and clinical course, confirmed in 1978 by mediastinal lymph node biopsy specimen showing noncaseating granulomata. He has taken prednisone