A 78-year-old female with stroke and hydrocephalus post-ventriculo-peritoneal shunt insertion presented with shortness of breath, productive cough, and fever that had been present for several days. Physical examination revealed basal crackle and rale over the left low lung (LLL) field. Chest radiograph (Fig. 1) showed an alveolar pattern involving LLL and a left-side pleural effusion. In addition, we observed multiple calcified nodules over the whole lung field. No specific occupational exposure was recalled.
