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Internal Medicine

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Harsh Sura
Nader Guma

A 28-year-old woman is hospitalized with a 5-day history of chest pain, fever, and cough with green sputum. Two weeks ago, she developed an influenza-like illness and seemed to improve before the onset of the most recent symptoms. She has no other medical conditions and takes no medications.

On physical examination, temperature is 38.6 °C (101.5 °F), blood pressure is 150/90 mm Hg, pulse rate is 112/min, and respiration rate is 28/min. Oxygen saturation is 96% breathing ambient air. Crackles are heard at the right lower lung base on pulmonary auscultation. The remainder of the physical examination is normal.

Blood and sputum cultures are obtained. COVID-19 testing is negative.

Chest radiograph shows a right lower lobe infiltrate.

Empiric therapy for community-acquired pneumonia is initiated with ceftriaxone, azithromycin, and vancomycin.

Ceftriaxone and azithromycin are discontinued on hospital day 2 when blood and sputum cultures return positive for methicillin-resistant Staphylococcus aureus with…


Mazen Kherallah
Nader Guma
Mizba Baksh

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Harsh Sura
Nader Guma

This pt presented to ED c/o chest pain x 2h

Also c/o headache and blurred vision

PMHx only significant for ETOH use disorder

No hx of trauma

No medications

Vitaly stable


Mazen Kherallah
Amna Khan
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