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A man in the late 20s presented with shortness of breath, pleuritic chest pain, cough and fever that progressively worsened during the past 2 days. In the past 3 months, he has become lethargic, with loss of appetite, loss of weight and is progressively emaciated (estimated weight 50 kg). He is an active smoker, with a 10-pack-year history. He denies any previous medical history or any hospitalisations.