A 55-year-old African-American man presented with a week-long history of cough with blood-streaked sputum. He denied fevers, night sweats, weight change, and sinus symptoms. He was physically active and had no dyspnea on exertion. He reported gastroesophageal reflux symptoms but denied any other complaints. His medical history included diverticulosis and depression. He took no medications. He was an active smoker with a 60-pack-year smoking history. In addition, he smoked crack cocaine with reported use 3 months prior. He denied alcohol or IV drug use. He had no significant travel, occupational, or exposure history.