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Unknown #782
A 79 year old man living in a nursing home has COPD, a lifetime history of heavy smoking, and hypertension. His caregivers note that he is exhibiting rigor, has a temperature of 103°F, and lacks his normal alertness. Vital signs include a blood pressure is 165/90, a pulse of 128 beats per minute, a respiratory rate of 32 breaths per minute, and a pulse oximetry on room air of 80%. He is transferred to an acute care facility where a chest X-ray reveals a right lower lobe infiltrate and his white blood cell count is 18,000/μL with a marked left shift. He has thick, foul-smelling yellow-green sputum. A sample of the sputum was grown in duplicate on trypticase soy agar (TSA) and blood agar.
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