45-year-old Male with significant PMH, presents with a cough of one week duration, initially productive of thick green sputum, now sputum is thicker and unable to produce sputum as efficiently. He also c/o chest pain, dyspnea on exertion and fever. He denies chills but muscle aches. He never had similar symptoms before and does not follow with a regular doctor. Physical examination: Vital signs 39-113-22-167/103 He looks in moderate respiratory distress with mid sentence pauses and tachypnea.
Chest: Crackles and dullness at the right base CVS: Tachycardic but regular CBC showed leukocytosis of 11.9 with bandemia, EKG was done and showed sinus tachycardia ABG: PaO2 62 mmHg, SpO2 90% on RA CXR and Chest CT images of heart and lung window is attached. Patient is on IV ABx - Cefotaxime 1g and Azithromycin 500 mg. What is the diagnosis? Any other test to be done before commencing treatment?
