MRCP2-2611

MRCP2-2611

A 68-year-old woman presents with a febrile illness lasting one week. She was prescribed amoxicillin for cough and right-sided pleuritic pain but did not finish the course. She developed a severe headache and increased confusion one day ago. She has a history of diabetes mellitus managed with metformin and sitagliptin. On examination, she has herpes labialis, a BP of 100/80 mmHg, and a regular pulse of 88. She is pyrexial with a temperature of 38.8 °C. Her GCS is 13, and there is neck stiffness and meningism. Fundi are not visible. Basal crackles are heard at the right lung base. What is the most likely cause of the lung findings in this 68-year-old woman?