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ABSTRACT: A 71-year-old male presented to the Accident and Emergency department with dyspnoea and hypotension following a 1 week history of fever and cough. The only previous illness was type II diabetes mellitus for which he took metformin and glimepiride. The laboratory analysis performed on a K(2) -EDTA sample showed haemoglobin 13.2 g/dL, total white cell count 6.04 x 10(9) /L with neutrophils 0.79 x 10(9) /L and platelet count 315 x 10(9) /L. © 2012 John Wiley & Sons A/S.