At autopsy the lungs showed areas of consolidation with microabscess formation. He cools his cabin with an evaporative cooler in which algae is allowed to grow. He develops a rapidly progressive pneumonia. Gram stain shows numerous neutrophils, few squamous cells, but no bacteria. No bacteria grow on routine agar plates or in liquid cultures designed for Mycobacterium species.
Growth does occur, however, on special agar plates containing buffered charcoal yeast extract.
His forced expiratory time is 3 seconds and clubbing of fingers is noted. Increased residual volume. Reduced diffusing capacity. Reduced forced vital capacity. He also has a history of severe chronic cough with copious amounts of foul-smelling purulent sputum, and dyspnea.