Reference no: EM133572393

Case Study: Jon Doe is a 66-year-old man presenting with 3 days of coughing up thick yellow sputum, shortness of breath, fever, and chills. He states his chest hurts when he breathes. He denies headaches, rhinorrhea, sinus pain, and nausea. He reports no exposure to sick individuals.

• Medications: lisinopril 10 mg a day by mouth

• Allergies: no known drug allergy

• Social history: smokes 1 pack of cigarettes per day (has done so for 30 years); denies alcohol use; works as a landscaper. Physical exam: • Vital signs: temperature 101.3°F; pulse 101 beats per minute; respiratory rate 23 per minute; blood pressure 142/84 mmHg; pulse oximeter 93%

•General: ill and tired appearance, coughing during a visit with thick yellow sputum noted

• HEENT: unremarkable

• Neck: small anterior and posterior cervical nodes

• Cardiovascular: unremarkable

• Lungs: right basilar crackles with dullness to percussion in the right lower lobe

• Abdomen: unremarkable.

QUESTIONS:

1. What are your differential diagnoses? List at least 5 and provide the pertinent positives & pertinent negatives.

2. What is the most likely diagnosis and pathogen causing this disorder? Discuss the data that support your decision.

3. What diagnostic test, if any, should be performed? Please provide a rationale.

4. Develop a treatment plan for this patient. Please include pharmacological and non-pharmacological treatment, education, follow-up, and disposition.