A 77-year-old woman with a medical history of hypertension and “asthma,” which had been diagnosed 3 months earlier, presented to her primary care physician with a 1-week history of fever, chills, increasing dyspnea on exertion, and cough productive of green sputum. The patient’s social history was negative for smoking as well as for exposure to second-hand smoke. Otherwise, her surgical, family, and social history were unremarkable. Her asthma was treated with fluticasone/salmeterol and albuterol. A review of body systems was negative other than the presenting complaints. The patient was afebrile and slightly hypertensive with otherwise unremarkable vital signs. A physical examination revealed a mildly obese, elderly patient in no respiratory distress with focal wheezing in the right upper lung field. Neither her wheezing nor dyspnea on exertion was relieved with the use of albuterol.