Review Question - QID 210780

A 65-year-old woman presents to the emergency department with shortness of breath. She is an immigrant and does not speak English, but it is clear she is struggling to breathe. You observe the patient struggling to breathe and coughing up large amounts of mucous. A phone call to her home nurse reveals that she has a past medical history of diabetes for which she is not currently taking her medications. She also states the patient recently recovered from a long flight back from her native country where she was visiting a relative in prison. Her temperature is 99.1°F (37.3°C), blood pressure is 167/108 mmHg, pulse is 112/min, respirations are 25/min, and oxygen saturation is 78% on room air. A chest radiograph is obtained as seen in Figure A. Physical exam reveals a distressed woman who is not cooperative with the exam secondary to her discomfort. Which of the following is the most likely diagnosis?