An atypical pneumonia
A 47 year old Zimbabwean woman presented with gradual onset shortness of breath of two months’ duration. She was breathless at rest, with a non-productive cough, and had had a fever for one week. She had no history of haemoptysis or night sweats but had lost 5 kg in weight over two months. No cardiac symptoms were elicited. She had no previous medical problems, history of smoking, or recent foreign travel.
On examination, she had a regular pulse of 122 beats per minute and a respiratory rate of 22 breaths per minute. Her temperature was 39°C and she had an oxygen saturation of 91% on air. There was no palpable lymphadenopathy. Her chest was resonant to percussion, with vesicular breath sounds and no added sounds. Examination of all other systems was normal. A chest radiograph was taken.
(1) Describe the chest radiograph findings.
(2) What is the differential diagnosis