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Text Box: Question: A 74-year-old woman with a remote history of polycystic kidney disease and left renal transplantation presented with complaints of a chronic cough productive of iridescent green sputum of 2 years’ duration. She reported gradually increasing bronchorrhea to the point where she would expectorate copious amounts and described it as "very bitter tasting." Multiple previous sputum cultures were negative for acid-fast bacilli, fungi, and bacteria other than normal flora. She had been treated with various courses of oral antibiotics, none of which altered her clinical course. Additionally, she reported a green discoloration to her tongue, which did not improve with aggressive oral hygiene (Figure A). A 30-lb weight loss was noted, but she denied fever, chills, or abdominal discomfort. On physical examination, she was found to be afebrile and cachectic with an irregular liver edge palpable 15 cm below the costal margin. Laboratories revealed a white blood cell count of 5.4  109, hemoglobin of 11.2 g/dL, platelets of 120/mm3, total bilirubin of 0.8 mg/dL, and normal coagulation studies. A chest radiograph revealed left upper lobe scarring and a large subdiaphragmatic calcified hepatic cyst (Figure B). A sputum gram stain was negative for polymorphonuclear leukocytes, but the culture of sputum obtained at this time revealed Bacteroides fragilis. What is the diagnosis?           Mission

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