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[67] All other clinically indicated respiratory infectious disease testing (e.g., urine antigen for Streptococcus pneumoniae and Legionella, sputum culture if productive cough, bronchoalveolar lavage culture if done, blood culture, human immunodeficiency virusrelated opportunistic respiratory infections if appropriate) must be negative and [67] No evidence in medical record of alternative plausible diagnoses (e.g., cardiac, rheumatologic, or neoplastic process)

Researchers have found litter in about 70 percent of seabirds and 30 percent of sea turtles