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Severe community-acquired pneumonia with sepsis — RCPSC EM MCQ

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ModerateRespiratory emergenciesSevere community-acquired pneumonia with sepsisRCPSC EM

A 68-year-old woman from a long-term care home presents with fever, cough, confusion, and hypotension. Respiratory rate is 32/min, oxygen saturation 89% on room air, lactate is 3.8 mmol/L, and chest radiograph shows right lower lobe consolidation. What is the most appropriate investigation?

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Correct answer: D — Blood cultures before antibiotics if this does not delay treatment

In septic pneumonia, blood cultures are appropriate before IV antibiotics when they can be obtained promptly, but cultures must not delay treatment and resuscitation.

Reference: Surviving Sepsis Campaign; Canadian pneumonia guidance