Figure 1a Growth chart of the patient, showing steady borderline growth on 3^rd centile (assessed by program Auxo 2018©Dr.PetrLesný, Hana Krasnicanova). Figure 1b Anteroposterior chest radiograph taken on admission demonstrating bilateral infiltrative changes and reduced transparency of lungs, in the left middle and lower lung field almost homogeneous reduction, with inflammatory infiltration.

1^st Challenge point :

The patient had no notable past medical history and was fully vaccinated according to the Czech national schedule (including pneumococcal vaccine), yet experienced an uncommonly rapid progression of respiratory insufficiency, with fever and night sweats. His chest X-ray scan showed an alarming image of markedly reduced translucency.