TY - JOUR T1 - Is it just an infection? JF - Breathe JO - Breathe SP - e100 LP - e104 DO - 10.1183/20734735.021518 VL - 14 IS - 3 AU - Athanasia Pataka AU - Serafeim Chrysovalantis Kotoulas AU - Evdokia Sourla AU - Evangelia Panagiotidou AU - Vasilios Bagalas AU - Katalin Fekete Passa AU - Ioannis Stanopoulos Y1 - 2018/09/01 UR - http://breathe.ersjournals.com/content/14/3/e100.abstract N2 - A 75-year-old man (body mass index 24.49 kg·m−2) presents to the emergency department with fever, myalgia and dyspnoea, which he has had for the last 4 days. He quit smoking 15 years ago (40 pack-years). His only medical history is hypertension treated with valsartan and amlodipine. He travelled recently and stayed in a motel. On admission, his temperature is 38.7°C, blood pressure 132/67 mmHg, heart rate 102 beats per min and respiratory rate 24 breaths per min. Arterial blood gases (ABG) analysis shows severe hypoxaemia with arterial oxygen tension (PaO2) 47.1 mmHg (6.3 kPa), arterial carbon dioxide tension (PaCO2) 40.9 mmHg (5.5 kPa), pH 7.464, HCO3− 28.4 mmol·L−1 and arterial oxygen saturation (SaO2) 84.2% while breathing room air. Laboratory tests show anaemia (haemoglobin 10.7 g·dL−1), elevated white blood cells (11 420 per μL; 92.0% neutrophils and 4.6% lymphocytes), elevated C-reactive protein (19.97 mg·dL−1) and hyponatraemia with serum Na+ 127 mmol·L−1. The rest of laboratory tests are normal. Chest radiograph showa infiltrates in both lungs. Antibiotic therapy with intravenous ampicillin/sulbactam 3 g per 6 h and antiviral therapy with oral oseltamivir 75 mg per 12 h are initiated.Is it just an infection or something more? http://ow.ly/HEcH30lSO6a ER -