03-03-2009, 06:53 AM
A 35-year-old male veterinary doctor presents to the emergency department with complaints of fever, dry cough, and headache for the last three days. He is a non-smoker and non-alcoholic. His past medical history is significant for an appendectomy performed 14 years ago. His temperature is 37.8 C (100 F), pulse rate is 110/min., respiratory rate is 18/min. and blood pressure is 110/80 mmHg. Auscultation of the lungs reveals crackles and tubular breath sounds in the right lower lobe. Abdominal examination reveals mild splenomegaly. Chest x-ray shows a focal consolidation of the right lower lobe. Pulse oximetry shows 96% oxygen saturation at room air. Which of the following is the most appropriate next step in the management of this patient?
A) Admit the patient and treat with empirical intravenous ceftriaxone awaiting serological results
B) Admit the patient and treat with oral Augmentin-clavulanate awaiting serological results
C) Give empirical clarithromycin awaiting serological results and follow up on an outpatient basis
D) Give empirical doxycycline awaiting serological results and follow up on an outpatient basis
A) Admit the patient and treat with empirical intravenous ceftriaxone awaiting serological results
B) Admit the patient and treat with oral Augmentin-clavulanate awaiting serological results
C) Give empirical clarithromycin awaiting serological results and follow up on an outpatient basis
D) Give empirical doxycycline awaiting serological results and follow up on an outpatient basis