Correct!
1. Begin empiric antibiotics for community-acquired pneumonia.
The patient is on no immunosuppressives other than 5 mg of prednisone. Bronchoscopy with bronchoalveolar lavage seems overly aggressive. There is no justification to increase the dose of corticosteroids.
Over the next 3 days the patient’s condition deteriorated. She was transferred to the intensive care unit and oxygen was gradually increased. A repeat chest X-ray revealed diffuse consolidation (Figure 3).
Figure 3. Repeat portable chest X-ray. (To view Figure 3 in a separate, enlarged window click here).
The patient required high-flow oxygen she was electively intubated. A repeat thoracic CT scan confirmed the diffuse consolidation (Figure 4).
Figure 4. Representative images from the repeat thoracic CT scan in lung windows. (To view Figure 4 in a separate, enlarged window click here).
What should be done next? (Click on the correct answer to be directed to the fourth of 6 pages)
