Cough is a symptom of neoconiosis, but cough is not a definitive diagnosis of infection with neoconiosis. In addition to cough, patients infected with neoconiosis usually have fever, malaise, and progressive dyspnea; in severe cases, this can lead to acute respiratory distress syndrome, septic shock, and uncorrectable metabolic acidosis and outgoing coagulopathy. Some patients may have a mild onset of symptoms or may not have significant fever. Nucleic acid testing is required to confirm the diagnosis of neoconiosis, so a simple cough may not necessarily be neoconiosis.