Young Man With Pain in the Chest and Pulmonary Infiltrate in the Left Lower Lobe

History A 32-year-old, previously healthy man had a five-day history of worsening dull, constant, left-sided anterolateral pain in the chest accompanied by several nonbloody diarrheal stools. No dyspnea, recent or remote trauma, fever, cough, or prior similar symptoms were present. He had lifted heavy weights (36 kg to 50 kg [80 lb to 110 lb]) on every other day during the preceding two months as conditioning exercises. Lifting exercises such as curls, bench press, and "squats" with Valsalva's maneuver were performed by him as late as the evening before the symptoms began. A roentgenogram of the chest obtained four years earlier was unavailable but was reportedly normal. Physical examination findings were normal except for dullness to percussion and diminished breath sounds over the base of the left lung. Complete blood cell count, screening chemistry findings, amylase level, and urinalysis results were normal. Roentgenograms of the chest are shown in Figs