A 51-year-old, African-American, homosexual man with HIV infection for 5 years presented with worsening shortness of breath on exertion, dry cough, and generalized fatigue of 2 weeks in duration. He denied hemoptysis, fevers or chills, night sweats, diarrhea, dysuria, or weight loss. His medical history was significant for HIV-related diseases including Pneumocystis jirovecii (formerly Pneumocystis carinii) pneumonia, Candida esophagitis, adrenal insufficiency, and community-acquired pneumonia. He was a smoker but denied recent alcohol or illicit drug use. The patient was prescribed multiple medications including highly active antiretroviral therapy (HAART), dapsone for P carinii pneumonia prophylaxis, fluconazole, and fludrocortisone but was noncompliant with medications.