A 47-year-old male with past medical history of hypertension, diabetes mellitis type 2, tobacco use and hyperlipidemia presented to the emergency department with nausea, vomiting, and shortness of breath of 1-week duration. He reported nausea and vomiting for one week which failed to improve with ondansetron. He also noted shortness of breath on minimal exertion for one week. Shortness of breath was associated with productive cough of yellow sputum. On initial assessment, he was hypoxic, requiring 4 L oxygen via nasal canula to keep oxygen saturation above 90%.