Oxygen saturation was 97% by oximetry. He had no clubbing but had coarse crackles at the left posterior lung base on chest auscultation. There were no other abnormal findings. Laboratory studies showed a total WBC count of 25 X 106 cells/L, with normal levels of electrolytes, and normal results of renal and hepatic function tests. A chest roentgenogram showed consolidation in the left lower lobe.
The patient consented to an outpatient pharmaceutical trial comparing two quinolone antibiotics. A sputum culture, including a specific culture for Legionella species, did not grow any pathogens. Results of a Legionella urinary antigen test were negative. Throat and nasal swabs were also negative for Chlamydia and Mycoplasma species read more order antibiotics online. Results of paired acute and convalescent serology for Legionella pneumophila (serogroups 1 to 6), Chlamydia pneumoniae, Chlamydia psitacci, Chlamydia trachomatis, and Mycoplasma pneumoniae all showed no evidence of infection. The single blood culture grew an unusual form of B cepacia that was fully sensitive to ofloxacin (including both study drugs), cefotaxime, and piperacillin.
The recovery of the patient was uneventful, and he resumed normal activities, including competitive basketball, within 14 days of starting antibiotics. The results of a physical examination and spirometry 1 month after starting therapy were completely normal.