A 67-year-old man is admitted to the hospital with a fever, chills, cough, and shortness of breath over the past 6 days*
He has a history of diabetes and end-stage renal disease that requires dialysis, which he gets at a dialysis center near his home. He says that the cough has worsened, and he is now coughing up multiple tablespoons of thick green sputum each morning. He lives at home with his wife, has had no recent travel or sick contacts, and no recent hospitalizations.
His temperature is 101.3°F (38.5°C), pulse is 100 beats/min, his respirations are 22 breaths/min, and his blood pressure is 100/72 mm Hg. Pulse oximetry in room air shows an oxygen saturation of 92%. He can speak in 3-4 word sentences, his respiratory examination shows bibasilar crackles, and he has diminished breath sounds at the right middle and right lower lung fields.
Which of the following is the most likely diagnosis?
A. Aspiration pneumonia
B. Community-acquired pneumonia
C. Healthcare-associated pneumonia
D. Hospital-acquired pneumonia
E. Ventilator-associated pneumonia
Answer to be disclosed shortly!
* The present case appears in Medscape