Free BCEN Certified Emergency Nurse (CEN) Practice Question

The presentation of pleuritic chest pain, chills, productive cough, dullness to percussion, and egophony, particularly at the lung base, is suggestive of lobar pneumonia. Streptococcus pneumoniae is the most common cause of community-acquired lobar pneumonia and would be the likely causative organism in a patient with no significant medical history and this presentation. Haemophilus influenzae is a less common cause and more frequently associated with exacerbation of chronic bronchitis. Klebsiella pneumoniae tends to affect those with a history of alcoholism and is associated with a more severe presentation including 'currant jelly' sputum. Legionella pneumophila typically presents with gastrointestinal symptoms and hyponatremia, which are not mentioned in this scenario.