CASE 12
A 41-year-old white man was admitted with a 3-day history of high fever and dry cough. His initial symptoms progressed to include headaches, muscle aches, and confusion.
LABORATORY STUDIES
Diagnostic Work-Up
Table 12-1 lists the likely causes of illness (differential diagnosis). Investigational approach to delineating the etiology may include
Rationale: Legionella is associated with high fever, diarrhea, confusion, and headache, and Mycoplasma and Chlamydophila usually have a more indolent course. Viral pneumonias often present with typical symptoms of upper respiratory infection. C. psittaci, Coxiella, and Legionella usually have a specific history of exposure (e.g., birds, pigs, or environmental). Truly purulent sputum, as is seen in S. pneumoniae (a major cause of typical pneumonia) is uncommon with other listed pathogens.