The patient is a 57-year-old female who presents to the ED complaining of the shortness of breath which has been presents for approximately 2 weeks with cough with intermittent sputum production, nausea and vomiting. The patient is short of breath for 2 weeks and is comfortable only when lying down. She reports she has had vomiting for the past 4 days and is unable to eat anything. She is known to have HIV. She follows up every 3 months in the HIV clinic and is faithful to her antiviral medication. She is also known to have depression. Clinical review of her chart reveals that she has an elevated white count, increased MCV. She has a slight left shift with 82% segs. D-dimer is positive at 4.65. CO2 is 11 and 13. Her sodium is 133
