Question

A 45-year-old man presents with a 3-day history of fever (T max-103.5°F), chills, anorexia, diarrhea, and a non-productive cough. On general examination, vitals are as follows: pulse is 98/min, RR is 24/min, BP is 120/60 mm Hg, and temperature is 103.5 °F. There are coarse basal crepitations and scattered rhonchi on examination of the lungs. Other systems exam are normal. Chest X-ray (CXR) shows patchy alveolar infiltrates with consolidation in the lower lobe. Complete blood count reveals leukocytosis; sputum Gram stain reveals only a few polymorphonuclear (PMN) leukocytes, and no predominant pathogens.

What is the most likely diagnosis?

1. Tuberculosis
2. Klebsiella pneumonia
3. Cryptococcal pneumonia
4. Legionnaire's disease
5. Haemophilus influenzae

Answer 1

The most likely diagnosis for the 45-year-old man with fever, chills, anorexia, diarrhea, and a non-productive cough is Legionnaire's disease.

Step-by-step explanation:

The most likely diagnosis for the 45-year-old man with fever, chills, anorexia, diarrhea, and a non-productive cough, along with patchy alveolar infiltrates with consolidation in the lower lobe on chest X-ray, is Legionnaire's disease. Legionnaire's disease is caused by the bacterium Legionella pneumophila and is typically acquired through inhalation of contaminated water droplets. Symptoms of Legionnaire's disease include high fever, cough, and shortness of breath. Treatment involves antibiotics such as levofloxacin or azithromycin.