Mr. K. was a 28-year-old professional ice skater who presented to the emergency room with shortness of breath that had gotten worse over several weeks, accompanied by left pleuritic chest pain, cyanosis, and a cough productive of green-brown sputum. He had been unable to take food well for about 10 days because of shortness of breath and general malaise.His past medical history included an episode of esophageal candidiasis diagnosed by endoscopy 4 months prior to admission. He had been otherwise healthy. He was homosexual with multiple partners. An HIV test was done 1 year previously, but he never found out the result. He had avoided regular medical care. He was from Australia and had no kin in the United States.