system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 36-year-old woman comes to the physician because of a 4-day history of fever, malaise, chills, and a cough productive of moderate amounts of yellow-colored sputum. Over the past 2 days, she has also had right-sided chest pain that is exacerbated by deep inspiration. Four months ago, she was diagnosed with a urinary tract infection and was treated with trimethoprim/sulfamethoxazole. She appears pale. Her temperature is 38.8°C (101.8°F), pulse is 92/min, respirations are 20/min, and blood pressure is 128/74 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 99%. Examination shows pale conjunctivae. Crackles are heard at the right lung base. Cardiac examination shows no abnormalities. Laboratory studies show:
Hemoglobin 12.6 g/dL
Leukocyte count 13,300/mm3
Platelet count 230,000/mm3
Serum
Na+ 137 mEq/L
Cl- 104 mEq/L
K+ 3.9 mEq/L
Urea nitrogen 16 mg/dL
Glucose 89 mg/dL
Creatinine 0.8 mg/dL
An x-ray of the chest shows an infiltrate at the right lung base. Which of the following is the most appropriate next step in management?"
assistant
Outpatient treatment with oral doxycycline