Pneumonia USMLE Step 1 Practice Question
A 57-year-old man with bacterial pneumonia remains febrile (38.9°C) despite 5 days of ceftriaxone. He presents with pleuritic chest pain, dyspnea, and productive cough. Vital signs: BP 128/82, HR 102, RR 22, SpO2 92% on room air. Thoracentesis yields thick purulent fluid with glucose 18 mg/dL, pH 6.8, and elevated LDH. Chest X-ray shows left lower lobe consolidation with pleural effusion. He denies recent travel or immunosuppression. Which diagnosis best explains these findings?
Answer choices
- ALung abscess
- BPulmonary embolism
- CTransudative pleural effusion from congestive heart failure
- DPleural effusion
- EEmpyemaCorrect answer
- FParapneumonic effusion without bacterial infection
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