Question

A 70 year old man presents with fever, productive cough and pleuritic chest pain. He was discharged from hospital 10 days ago after a hip fracture repair. He is confused, blood pressure is 86/50 mm Hg, heart rate 120 and lactate 4.5 mmol/L. What is the most appropriate initial management?

Accepted Answer

Start broad spectrum intravenous antibiotics, aggressive intravenous fluids and arrange ICU level care

Answer

Give oral antibiotics and obtain a chest X ray

Answer

Delay antibiotics until sputum culture results are available

Answer

Treat with antiviral medications only

Answer

Observe without treatment because confusion is common in the elderly

Practice question

A 70 year old man presents with fever, productive cough and pleuritic chest pain. He was discharged from hospital 10 days ago after a hip fracture repair. He is confused, blood pressure is 86/50 mm Hg, heart rate 120 and lactate 4.5 mmol/L. What is the most appropriate initial management?