68 year old patient with Alzheimer disease was brought to the emergincy room.?

By the staff of a local nursing home.He presented as lethargic with a sallow complexion.He had and admission temperature of 102.4F and a respiratory rate of 33/minute.During respiration, the right side of his chest moved better than the left. He showed dense consolidation of the lower lobe of the left lung on physical exam. A sputum sample revealed blood and a gresenish color. A chest xray showed tight consolidation of the left lung with evidence of formation of cavities in the lung tissue from cytotoxic damage. The patient complained of chills in the exam room, combined with his fever. A smear of his sputum demonstrated no acid-fast bacteria

I guess I missed the question but assume you are looking for a diagnosis....It is hard to say could be aspiration pneuminia but that is much more common in the right mid lobe of the lung vs left. Does the patient have a history of smoking or working in a coal mine or with asbestos? You need to present all of the info here if you are expecting help. HOw was the temperature taken? if it was rectal then it isn't such a high fever, but if that is axilary then you add a degree which makes the situation more concerning. The resp rate is high so you should have given oxygen via nasal cannula at 2 liters per minute as comfort due to shortness of breath. What did the nail beds look like...pink or dusky? Is the person dehydrated and in need of IV fluid or just IV antibiotics to help decrease the fever? And just because the person has Alzheimers does not mean they are not still a person, you can still talk to them and ask them questions, they sometimes have lucid moments. Also, the family should be able to give you oral history or you could even call the nursing home. Some patients have been at long term care for years and the staff get to know them pretty well. Good luck, I hope I helped..........P.S. I am a nurse in long term care.

Sounds like a virus. Probably has had pneumonia or at least bronchitis in the past and has scaring from that. I'd say Tylenol for the fever and something like Mucinex for the mucus. Also might benefit from a nebulizer treatment.

Any signs of trauma to the left thorax area?

How about pseudamonous?

Viral Pneumonia?

This patient could be having lung abscess from long -standing pneumonia complicated by pseudomonas infection of the abscess cavities.The laboratory should not only look for acid fast bacteria in the sputum, a Gram stain should also be carried out.
This patient needs aggressive treatment with oxygen therapy.Adequate chest physiotherapy and broad spectrum antibiotic cover with one of the quinolones or a third generation cephalosporin which must be administered parenteral.If possible bronchoscopic drainage of large abscess cavities could be tried.
This patient should be made to be ambulant as early as possible or limb exercise should be quickly introduced to prevent deep vein thrombosis from causing his death eventually.

he needs advanced ambrotose powder. his cells cannot process
glucose.

pneumonia.

could be pneumonia but because you stated the patient has Alzheimer disease i would have to say aspiration pneumonia as they frequently have resistence to or difficulty in swallowing in later stages