| Summary points: | A morbidly obese 60-year-old with type 2 diabetes, asthma, and history of gallstones presents with breathlessness, abdominal pain, which was worse on coughing, and fever, and a provisional diagnosis of pneumonia. This case report describes the clinical presentation, history, physical examination, blood work, radiological findings, and outcome. The authors discuss the challenges associated with diagnosis in this patient and suggest ways that these might have been overcome. |