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A teacher in his 50s was referred urgently following an abnormal chest X-ray and a 4-week history of dark-green, blood-speckled productive cough, left-sided pleuritic pain, fevers, night sweats and unintentional weight loss with reduced appetite. He had received antibiotics from his general practitioner prior to referral. Born in the UK, he had no comorbidities, was an ex-smoker, had no recent foreign travel and reported no contact with animals. Examination showed reduced air entry at left lung base.