Pneumonia — Lobar vs Bronchopneumonia

A 68-year-old man with COPD presents with acute onset fever (39.2°C), productive cough with purulent sputum, and dyspnea for 2 days. Chest X-ray shows patchy infiltrates in multiple lobes with a bronchocentric distribution. Sputum Gram stain reveals gram-negative rods. What is the most appropriate immediate next step in management?

A 72-year-old woman with COPD and a recent history of aspiration during a stroke is admitted with a 5-day history of low-grade fever (38.2°C), persistent cough, and progressive dyspnea. On examination, scattered crackles are heard bilaterally over both lower lobes. Chest X-ray shows patchy infiltrates in multiple lobes without lobar consolidation. Sputum culture grows *Staphylococcus aureus* and anaerobes. What is the most likely pathological diagnosis?

A 62-year-old man with COPD presents with acute onset fever (39.2°C), productive cough with purulent sputum, and dyspnea for 3 days. Chest X-ray shows patchy infiltrates in the right lower and middle lobes with a bronchial distribution. Which investigation is most appropriate to confirm the diagnosis and guide antimicrobial therapy?

A 58-year-old woman with acute lobar pneumonia (left lower lobe consolidation on chest X-ray, fever 39.8°C, pleuritic chest pain) is admitted. Blood cultures are ordered. Which additional investigation is most specific for confirming pneumococcal pneumonia and determining penicillin susceptibility?

A 52-year-old man with acute onset fever, productive cough with rusty sputum, and pleuritic chest pain presents to the hospital. Chest X-ray shows consolidation in the right lower lobe. Blood culture is positive for Streptococcus pneumoniae. What is the drug of choice for community-acquired lobar pneumonia in this patient?