Chronic fever with weight loss that has not responded to antibiotics

How it presents

A woman of 55, a known case of DM, hypothyroidism and osteoporosis on medications, presented with a one month history of fever, not associated with chills, rigors or night sweat. One week later it was followed by a dry cough, which became productive of minimal whitish sputum one week after that. There was also a history of exertional SOB and left flank and posterior side of chest pain, and no hemoptysis.

Two lines in the history carry the weight. She received 5 days of oral antibiotics without improvement. And she had lost more than 10 kg in less than a month, from a baseline of 65 kg to 53 kg.