ABSTRACT
A 44-year-old man presented to his general practitioner complaining of general malaise of 1 week's duration and a 2-day history of abdominal pain, diarrhoea and vomiting. He was diagnosed with probable viral gastroenteritis and advised to return if his symptoms persisted. Four days later, he re-presented to the general practitioner with a cough and shortness of breath. His oxygen saturations were 86% on room air and he had crackles at both lung bases. He was brought to hospital by ambulance. His past medical history included gastro-oesophageal reflux disease and seborrheic dermatitis. He took 30 mg lansoprazole once daily only. He lived with his wife and owned a pet shop, in which they both worked. He had never smoked and drank 2–4 units of alcohol per week.
