A 72-year-old man is brought to A&E with a 2-day history of a productive cough and fevers. | Medibuddy
3rd August 2023

A 72-year-old man is brought to A&E with a 2-day history of a productive cough and fevers.

A 72-year-old man is brought to A&E with a 2-day history of a productive cough and fevers. His wife is concerned as he has not been eating and drinking much, and over the last few hours, he has become increasingly confused. On examination,he has coarse crackles on auscultation of his left lung.

The results are as follows:

Observations HR 102 bpm, RR 24/min, SpO₂ 96% (on air), BP 142/88 mmHg, T 37.8ᵒC
Bloods
  • Hb 152
  • WCC 13.8
  • Neutrophils 11.3
  • Na 149
  • K 4.2
  • Creatinine 144
  • Urea 8.4
  • CRP 84
Chest x-ray Increased opacification in the left lower zone

What would be the most appropriate initial treatment?

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