Correct!
3. Thoracic CT scan
There are at least two reasons to obtain a thoracic CT scan. First, the patient is profoundly hypoxic with an only mildly abnormal chest x-ray. This raises the possibility of an acute pulmonary embolus. The second is to better define the abnormalities seen on the chest x-ray. Unfortunately, Mycoplasma IgM is often falsely positive, and although it would not be wrong to empirically begin antibiotics, some skepticism should be maintained about the diagnosis (1). Similarly, it would not be wrong to begin to begin heparin for possible pulmonary embolism if there was a delay in obtaining a definitive study.
Representative views of the thoracic CT scan is shown in Figure 2.
Figure 2. Representative images from the thoracic CT scan in lung windows.
The thoracic CT angiogram showed no pulmonary embolus. Sputum and blood cultures showed no growth.
What is the next step in the patient's evaluation? (Click on the correct answer to proceed to the third of five panels)