{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T18:11:34Z","timestamp":1755799894322,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,7,28]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>A farmer in his mid-60s with diabetes mellitus and heart failure on medications presented with non-resolving pneumonia for the past 1 month. The patient was initially treated for community-acquired pneumonia but was referred to us when there was no resolution of symptoms. The patient had anaemia, neutrophilic leucocytosis, acute kidney injury, raised D-dimer and C-reactive protein, and a positive cytoplasmic anti-neutrophil cytoplasmic antibody. After an extensive workup, a diagnosis of granulomatosis with polyangiitis was made. The patient was treated with oral glucocorticoids for 4 weeks. On follow-up, the patient showed drastic improvement clinically, biochemically and radiologically. Pulmonary infarction can mimic pneumonia and should be considered in patients having risk factors for embolism. A peripheral wedge-shaped opacity (Hampton\u2019s hump) is often a classical sign of pulmonary infarction. Thus, this case emphasises the importance of rare presentation, diagnostic clues and management strategies.<\/jats:p>","DOI":"10.1136\/bcr-2025-267031","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T05:35:16Z","timestamp":1755668116000},"page":"e267031","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Non-resolving pneumonia revealing ANCA vasculitis"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5035-2299","authenticated-orcid":false,"given":"Ashwin","family":"Karnan","sequence":"first","affiliation":[{"name":"Respiratory Medicine, Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Babaji","family":"Ghewade","sequence":"additional","affiliation":[{"name":"Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulhas","family":"Jadhav","sequence":"additional","affiliation":[{"name":"Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek","family":"Alone","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"2025081922351209000_18.8.e267031.1","unstructured":"UpToDate . 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