The patient has been lost to me for follow up. A few months prior to her visit to the ER that prompted her admission she had previously been followed at clinic in a routine fashion, had come in for her 6 weeks pp check and had no difficulty at that time. X-ray taken at that time revealed a pneumonia for which she was given antibiotics. She has, however, recently been on Levaquin, Zithromax, Proventil and Promethazine with codeine all within the previous week for her pneumonia. Review of systems as above.
Tympanic membranes are clear.
Nasal pharynx reveals thin coryza, oropharynx has post-nasal drainage. Pt was able to move all extremities without difficulty. An EKG revealed a sinus tachycardia with a rate of 115. The costovertebral angles were sharp. There was a fluffy infiltrate in the right lower lobe, which is possibly early pneumonia, or edematous changes with the corresponding left changes obscured by the heart shadow.