A 57-year-old Japanese man with a history of hypertension was admitted to our hospital complaining of headache and fatigue that started 3 days before. On admission, his consciousness was clear. He had an elevated temperature (39.8 °C), with a regular heart rate of 69 beats per minute, increased respiratory rate (30/min), and low oxygen saturation (90% in room air). Physical examination revealed an inspiratory coarse crackle on the left chest auscultation. There was no abdominal pain. A chest x-ray showed massive consolidation of the left lung (Fig. 1A).
