Correct!
5. All of the above
The chest x-ray shows bilateral consolidations. A thoracic CT scan is indicated to better define the consolidations. A coccidioidomycosis serology is nearly always indicated for any chronic pneumonia in Arizona. Although sputum Gram stain and culture are generally not helpful in the initial diagnosis or treatment of community-acquired pneumonia especially those who have received antibiotics, most still order this in the work-up of a pneumonia (1).
Her Gram stain and sputum culture revealed only normal flora. Coccidioidomycosis serology showed the IgM within normal limits and an IgG was indeterminate. Her thoracic CT scan is shown in Figure 2.
Figure 2. Representative images from the thoracic CT scan in lung windows.
Which of the following are considerations at this point? (Click on the correct answer to be directed to the third of seven pages)