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A 67-year-old man presented to the emergency department with a five-day history of nonproductive cough and progressive dyspnea and a one-day history of right-sided pleuritic chest pain. Four days earlier, left-lower-lobe pneumonia had been diagnosed and treatment with oral antibiotics had been initiated. On examination, the patient had marked respiratory difficulty, with a respiratory rate of 28 breaths per minute. His lung fields were clear to auscultation. An arterial blood gas measurement obtained while he was breathing room air showed a pH of 7.46, a partial pressure of carbon dioxide of 34 mm Hg, and a partial pressure of oxygen . . . [Full Text of this Article] |
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