How would you follow-up with this patient

L.F. is a 20-year-old male college student with a 2-week history of cough and increased sputum production who presents to your clinic with new chest pain when he coughs, shortness of breath, intermittent fever and chills and blood-tinged sputum. HPI: Cough treated with guiafenesin with dextromethorphan obtained form roommate Allergies: sulfa (nausea) Physical examination: GEN: DOE and pleuritic chest pain VS: BP 120/75 HR 95 T 100.5 RR 35 WT 90kg HT 6’4″ CHEST: LUL is CTA with significantly decreased breath sounds. There are E-to-A changes in the LLL and across the middle of the right lung field. COR: tachycardic, no MRG HENT: WNL ABD: WNL GU: WNL NEURO: WNL SKIN: WNL Chest X-ray: Consolidation of the inferior segments of the LLL. Remainder of the lungs are clear. Heart size WNL. Sputum Gram Stain: many WBC, few epithelial cells, moderate gram-positive cocci in chains and pairs Based upon what you learned in class and from your readings, what are the 2 most likely pathogens that would cause pneumonia in this patient? Based upon your answer to the above question, and the gram stain, what is the most likely causative microorganism in this patient? What would you prescribe for this patient to treat his infection, and what would you tell this patient about those medications (i.e. AE, monitoring of condition)? What other medications would you prescribe for this patient? How would you follow-up with this patient (i.e. under what circumstances would you see him back)?

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