Case Report A 42-year old man attended our emergency department with sudden onset of nausea, fever and cold sweats. In the days prior to presentation, he had developed a radiating pain in the thoracic spine. Furthermore, he had been suffering from dyspnoea on exertion for several weeks. He was a smoker, but had no significant past medical history. [download-attachments container="div" style="list" display_icon="1" display_count="1" display__size="0"]