Rare presentation of an old bug.

We highlight a rare presentation of infection in a 77-year-old woman with a clinical diagnosis of giant cell arteritis 2 months prior to presentation. She was started on 60 mg prednisone that was tapered to 10 mg after 4 weeks following her diagnosis. She presented with a 1-month progressive dyspnoea in the absence of any other symptoms. Her exposure history was significant only for a recent trip to Florida where she stayed at a hotel. Initial laboratory workup was significant for hyponatraemia (127 mmol/L). Workup including bronchoalveolar lavage (BAL) and induced sputum for gram stain, acid fast stain and bacterial culture were negative for pneumonia and other opportunistic infectious agents. However, BAL was positive for via PCR that was confirmed by a positive urinary antigen. The patient received treatment with levofloxacin that led to full resolution of her symptoms.