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A 42-year-old soldier presented to his local emergency department with an 8-week history of fever and cough with haemoptysis. A chest X-ray demonstrated right upper zone consolidation. He was prescribed amoxicillin for presumed community-acquired pneumonia (CAP) and discharged. His symptoms improved to the point where he felt well enough to go on a fishing trip to France. On return to the UK, he developed a mild headache, which worsened over a period of 3 weeks to the point where the pain was unbearable, leading to readmission.
He was normally fit, with no significant medical history. He mentioned a history of recurrent abscesses in the groin region over the previous 5–6 years. These typically enlarge, discharge spontaneously and then heal. He had not sought medical attention for these. At the time of this presentation, he had no active abscesses. Apart from his trip to France, he had no recent travel …
Footnotes
Contributors MR drafted the manuscript and is the guarantor. NLR, EKN and LL were involved in the care of the patient and reviewed the manuscript.
Funding MR is funded by an MRC Clinical Research Training Fellowship (MR/Y000447/1).
Competing interests EKN received royalties from a medical textbook and has received travel expenses for attending meetings by the British Association of Spinal Surgeons. No other competing interests.
Provenance and peer review Not commissioned; internally peer reviewed.