27 y.o. male who presents with continued fevers at home MAXIMUM TEMPERATURE 103, cough, pain with inspiration and recently being treated with Azithromycin and Avelox by his family physician. He completed each course of antibiotics without improvement. He had a chest x-ray at an urgent care as been diagnosed with pneumonia 2 weeks ago. Continues to have cough that is productive, pain with inspiration and fevers at home.
During initial assessment, patient denied any history of immunosuppression, HIV, on chronic steroids.
Review of systems was remarkable for fevers, chills, fatigue and 20 lbs weight loss.
Vitals: HR 133 BP 117/82, temp 98.4, RR 18, 95% on RA
HEENT: No lymphadenopathy, evidence of thrush on exam
Respiratory: Does appear in acute respiratory distress. Lungs clear to auscultation bilaterally. No wheezes rales or rhonchi
Rest of physical exam was unremarkable.
Sinus tachycardia, no ST elevations or T-wave inversions. No signs of STEMI