What’s Your Diagnosis? Community-Acquired Pneumonia in the ED
January 20, 2021


Posted by Andy Jagoda MD in: What's Your Diagnosis , trackback

Welcome to this month’s What’s Your Diagnosis Challenge!

But before we begin, check to see if you got last month’s case on Evaluation and Management of ST-Segment Elevation Myocardial Infarction in the Emergency Department right.

Case Presentation: Community-Acquired Pneumonia in the Emergency Department

A 30-year-old man with no significant medical history presents to the ED with 2 days of fever, cough productive of green sputum, and malaise…

  • Examination reveals left-sided rhonchi that do not clear with cough.
  • The patient has a heart rate of 105 beats/min and a temperature of 39.1°C. He is normotensive and hasa 95% oxygen saturation on room air.
  • Labs show a WBC count of 17K, but are otherwise unremarkable. X-ray shows a left-sided retrocardiacopacity concerning for pneumonia.
  • The patient is clearly symptomatic, but he is asking to go home.

Conclusion

You noted that the patient was otherwise well-appearing, and he did not have any risk factors for drug-resistant organisms or any other significant medical comorbidities. You prescribed amoxicillin 1 g orally, 3 times daily for 5 days. The patient called back to the ED and said he had improved clinically and was essentially asymptomatic by day 3. He was encouraged to complete his 5-day course of antibiotics.

Click to review this Emergency Medicine Practice Issue

Comments »

1. Camilo Mohar - March 3, 2021

The real diagnostic challenge is wether is PNA was bacterial or viral.

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