A 38-year-old man presents to his general practitioner (GP) with progressive dyspnea on exertion developing steadily over the past 2 months. He says that he is now unable to walk 100 m before becoming severely short of breath and having to stop. He also noted the development of a non-productive cough over a similar time scale and more recently developing a fever. He had never experienced anything like this before and was previously fit and well with no past medical history of note. In his social history he reported having unprotected sex with both men and women.
Examination On examination his respiratory rate was 22 per minute, fever (with a temperature of 37.9°C), a few crackles and wheezes over both lung fields. On the basis of the examination the GP sent the patient to the emergency department. In casualty, oxygen saturation was 90 per cent breathing air. Hematology results showed…
