An unusual non-resolving community-acquired pneumonia

We present the case of a 61-year-old male that was admitted to our Unit of Pulmonology for a suspected community-acquired pneumonia (CAP) with acute hypoxemic respiratory failure. However, despite many courses of empiric wide spectrum antibiotic treatment, the respiratory failure persisted and new bilateral migratory pulmonary opacities and serosal effusions appeared. The most common causes of non-resolving CAP were excluded and the combination of thrombocytopenia, autoimmune hemolysis, pleural and pericardial effusions in a patient with antinuclear antibodies ANA at a titer of 1:160 is diagnostic for systemic lupus erythematosus (SLE)