A healthy 53–years-old male presented to ED with fever and arthralgia for two days. On admission the patient was alert, oriented, febrile; thoracic exam revealed crackles in left basal area. Blood exams showed lymphocytopenia (490/mmc), thrombocytopenia, increased C-reactive protein (263 mg/l) with procalcitonin 0.37 ng/ml; chest CT scan revealed multifocal pneumonia (Fig.1a). Blood cultures and urinary antigen test for Legionella were performed, the last was negative. Empiric therapy with piperacillin-tazobactam and levofloxacin was started.
