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A man in the 70s, with a history of nasopharyngeal carcinoma (NPC), presented with a 2-day history of shortness of breath, productive cough and fever. He had been discharged from the ear, nose and throat department 15 years ago after completing radiochemotherapy and was deemed in remission. Other comorbidities include chronic obstructive pulmonary disease (COPD), hypertension, chronic kidney disease (baseline estimated glomerular filtration rate (eGFR) 30 mL/min/1.73 m²) and hypothyroidism.