A 37-year-old lumberjack had a sudden onset of fever with chills, pleuritic chest pain, and a productive cough. He was admitted to the hospital three days later with suspected multilobar consolidated pneumonia. His medical history included two episodes of cellulitis earlier that year, recurrent occurrences of otitis media in childhood, chronic giardia, intermittent episodes of thrombocytopenia and three episodes of pneumonia in the past. He had no other significant allergies and was not on any drugs. He was not a heavy drinker and smoked a packet of cigarette everyday.
Physical examination Vital signs: Temperature: 102°F Pulse rate: 122 beats/minute Respiratory rate: 24 breaths/minute Oxygen saturation: 92% He was generally thin and appeared ill. Bilateral tubular breath sounds were present in the lungs. All other physical examinations appeared to be normal. Laboratory examinations WBC…
