5. None of the above

This is an essentially normal portable chest x-ray.  There are no focal infiltrates or evidence of cardiomegaly. Although the heart/chest ratio approaches 1:2 the heart appears somewhat enlarged because the chest x-ray is a portable taken anterior to posterior.

Based on this initial evaluation, which is the next best step in management?

  1. Immediately begin antibiotic coverage for health care associated pneumonia
  2. Immediately begin antibiotic coverage for community acquired pneumonia
  3. Obtain CT angiogram of the chest
  4. Obtain high resolution CT of the chest
  5. Perform bronchoscopy with bronchoalveolar lavage

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