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Necrotizing pneumonia influenza MRSA — ABEM Board MCQ

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HardInfectious disease emergenciesNecrotizing pneumonia influenza MRSAABEM Board

A 34-year-old man arrives with fever, hemoptysis, and dyspnea after influenza-like illness. Triage acuity is ESI 1; BP 88/50 mm Hg, HR 138/min, SpO2 86%. Chest radiograph shows multilobar cavitary infiltrates. He is toxic appearing. Which of the following is the most appropriate next step in management?

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Correct answer: C — Start broad-spectrum antibiotics including MRSA coverage and ICU admission

Post-influenza severe cavitary pneumonia with shock suggests necrotizing MRSA pneumonia and requires broad empiric coverage and ICU care.

Reference: IDSA/ATS community-acquired pneumonia guideline