Case Scenario: Mr. Menendez is a 65-year-old man presenting with 2-3 days of coughing up thick yellow sputum, shortness of Breath, and fever (he did not check the actual temperature), 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 examination: vital signs - temperature 101°F; pulse 98 beats per minute; respirations 22 per minute; blood pressure 140/86 mmHg; pulse oximeter 93%.
General: ill and tired appearance, coughing during the visit with thick yellow sputum noted.
HEENT: unremarkable.
Neck: small anterior and posterior cervical nodes.
CV: unremarkable.
Lungs: right basilar crackles with dullness to percussion in the right lower lobe.
Abdomen: unremarkable.
1. What is the most likely diagnosis and pathogen causing this disorder?
2. Discuss the mode of transmission. Discuss the data that support your decision.
3. What diagnostic test, if any, should be done?
4. Develop a treatment plan for this patient.
5. Please provide references