Unusual presentation of a complicated community-acquired pneumonia resembling lung cancer

We report a case of an unusual presentation of a complicated community-acquired pneumonia resembling lung cancer in an adult male with a long history of fever and consumption syndrome. Chest X-ray showed a right lower lobe consolidation and CT of the chest confirmed those findings. The bronchoscopy demonstrated a mass obstructing the right lower lobe orifice and narrowing the intermedius and right bronchus. Although the picture resembled a lung cancer, two biopsies were consistent with chronic inflammation and features of squamous metaplasia. He received several courses of empiric antibiotics (moxifloxacin and macrolides) without improvement. Cultures yielded Streptococcus pneumoniae and the antibiogram indicated exhibited resistance to moxifloxacin. We started with Amoxicilin-Clavulanic with a clear clinical and radiological improvement. This is the first case report in USA of a community-acquired pneumonia resistant to moxifloxacin.