C. Pneumonia
Pneumonia typically presents with an acute onset of symptoms, including
fever, cough, dyspnea, pleuritic chest pain, and constitutional symptoms
like malaise and weight loss (16). However, in this case, the clinical
manifestation began three months ago, suggesting a chronic or indolent
process rather than an acute infectious etiology. While the presence of
consolidations on CT scan is consistent with pneumonia, chronic
pneumonia is less common and typically presents with more subtle
radiological findings, such as persistent infiltrates or fibrotic
changes (16, 17).
Given the chronicity of symptoms and the need to explore alternative
diagnoses, further diagnostic evaluation beyond typical pneumonia workup
may be warranted. This may include pulmonary function tests, autoimmune
serology, imaging studies to assess for structural lung disease or
malignancy, and possibly bronchoscopy with biopsy to obtain tissue for
histopathological examination.
While pneumonia remains a consideration in the differential diagnosis,
its probability is diminished by the chronic nature of the patient’s
symptoms over the past three months.