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A 49-year-old man presented with 3 months' productive cough. He denied weight loss, fever and haemoptysis. He was an ex-smoker of 10 pack-years and was a pedestrian in a road traffic accident 20 years ago. He sustained an open skull fracture that led to residual hemiparesis and cranial diabetes insipidus. Physical examination revealed a well-nourished man. He had normal vital parameters with a heart rate of 80 bpm, blood pressure of 115/80 mm Hg and oxygen saturation of 96% on room air. Coarse crepitations were auscultated over the lower third of the left hemithorax, and there was no clubbing or cervical lymphadenopathy. Neurological examination showed mild hemiparesis on the left, without cognitive or speech deficits. …
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