一名 41 岁女性有 3.5 个月的发烧、虚弱、咳嗽、排尿灼热病史，并伴有全身虚弱和体重明显减轻。胸部 X 光检查显示双侧浸润和双侧胸腔积液，检查结果提示社区获得性肺炎 (CAP)。然而，持续发烧、炎症标志物升高、N 末端 B 型利钠肽原 (NT-proBNP) 升高和盆腔积液使病程变得复杂。包括支气管镜检查和肺活检在内的广泛研究未能确定特定的病原体。排除了肺血管炎和淋巴瘤。抗生素和皮质类固醇治疗导致临床改善。虽然病因尚不清楚，但曾考虑过布鲁氏菌病和曲霉病，但通过高级检测排除了这种可能性。潜在的病因仍然难以捉摸，突出了具有非典型表现的 CAP 的诊断挑战。版权所有 © 2024，Goswami 等人。

A 41-year-old woman presented with a 3.5-month history of fever, weakness, productive cough, and burning micturition along with generalized weakness and significant weight loss. Chest X-ray revealed bilateral infiltrates and bilateral pleural effusion, and the workup suggested community-acquired pneumonia (CAP). However, the course was complicated by persistent fevers, elevated inflammatory markers, elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP), and pelvic fluid collection. Extensive investigations, including bronchoscopy and lung biopsy, failed to identify a specific pathogen. Pulmonary vasculitis and lymphoma were ruled out. Antibiotic and corticosteroid therapy resulted in clinical improvement. While the cause remains unknown, brucellosis and aspergillosis were considered but ruled out with advanced testing. The underlying etiology remains elusive, highlighting the diagnostic challenges in CAP with atypical presentations.Copyright © 2024, Goswami et al.