For three days, this patient has had a sore throat, fever and chills. Today, he feels progressively breathless.

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<p>Niall is a 35-year-old regular patient who phones the practice for advice.</p><p>For three days, he has had a sore throat, fever and chills. Today, he feels progressively breathless.</p><p>He lives alone and feels too unwell to leave the house.</p><p>Niall is usually well, has no past history of note and is fully immunised.</p><p>He is speaking in full sentences, but his breathing sounds laboured, and he sounds anxious.</p><p>The GP calls an ambulance to attend Niall’s home.</p><p>A lateral neck X-ray is taken on arrival in ED. An arrow marks the most pertinent finding.</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.