67yr old male with fever since 20days A 67 yr old male patient who was a daily wage labourer 5yrs back has come to the OPD with CHIEF COMPLAINT: fever•.• 20days Shortness of breath •.• 10days HOPI patient was apparently a symptomatic 5yrs ago then his daily rotuine was “Wakes up at 6am, complete his nature calls,brushes with neemstick, have’s his tea and takesbath , he takes rice as his breakfast and dinner, skips his lunch most of the times .spend his rest of the time with neighbours and watching tv sleeps at around 9pm” SOB was insidious in onset, gradually progressing from grade 1 to grade.2 , relieved on taking rest associated with cough since 10days no h/o orthopnea, PND Fever was continuous type no aggravating factors and relieved on taking medications then he went to an hospital . He was there for 2days and the fever and cough subsided ,discharged and was at home for 2 days with decreased appetite so he was eating less or no ,later he developed fever and approched us -a