An Atypical Presentation of Mycobacterium Avium Complex Pneumonia

48 year old African American Male patient with PMHx of HIV and Bell's palsy presented to the Emergency Room of a community hospital with high grade fever (102°f), cough, progressive loss of weight (20 pounds in under one month) and chest pain. He stated that he had been told sixteen years ago that he had HIV but was not started on treatment at the time. Patient denied any hemoptysis but endorses his chest pain as worse on deep inspiration, graded as 7/10 and associated with progressively worsening Shortness of Breath (SOB), Dyspnea on Examination (DOE) and increased sweating for nearly a month. Patient's PCP had done a chest-X ray which, according to patient, showed “spots on his lungs.” Prior to presentation in the hospital, patient had taken two seven-day courses of levofloxacin without any improvement.