A 57-Year-Old Man Who Just Returned from a Cruise to the Bahamas

A 57-year-old man who just returned from a cruise to the Bahamas comes to the emergency department with fever, nonproductive cough, and shortness of breath for the past 2 days.  He has also had a headache, abdominal pain, and diarrhea for a day.  The patient has a history of type 2 diabetes mellitus and has smoked a pack of cigarettes daily for 20 years.  He does not use alcohol or illicit drugs.  His temperature is 39.2 C (102.6 F) , blood pressure is 110/65 mm Hg, pulse is 80/min, and respirations are 18/min.  The patient's pulse oximetry shows 97% on room air.  Lung examination shows crackles bilaterally.  The abdomen is soft and nontender.  The patient seems confused at times during the examination.  His serum glucose is normal; serum sodium is 128 mEq/L.  Chest x-ray demonstrates bilateral interstitial infiltrates.  He is admitted to the ward.  Which of the following antibiotics should be given to this patient?

A) Amoxicillin/clavulanate
B) Ceftriaxone
C) Clindamycin
D) Levofloxacin
E) Vancomycin

Correct Answer:

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