Considering the presenting signs of productive cough, pyrexia, and crackles in the left lower lobe associated with consolidation in that area, this patient likely has community-acquired pneumonia (CAP). The etiology of this disease may be viral or bacterial, and the former could be suspected since the patient mentions that “something is going around at work,” which can be influenza. However, the man coughs up the greenish sputum, which may point to such bacterial infections as Hemophilus influenza, pneumococcal species, or Pseudomonas aeruginosa (Gamache, 2020). Initially, the patient’s fever should be managed with Acetaminophen 650 mg every eight hours. Since the patient has hypertension, five days of combination therapy is suggested: amoxicillin/clavulanate 875 mg twice a day with azithromycin 500 mg on the first day, followed by 250 mg daily (Metlay et al., 2019). He will be advised to take the entire course of antibiotics even if his condition improves earlier. Furthermore, the patient should be recommended to quit smoking at least until the symptoms subside, sanitate his hands properly, and wear a mask.
I agree with your diagnosis of CAP, but it is unclear if his liver and kidneys function normally. In fact, it was mentioned in the case that the man was earlier diagnosed with hypertension, which has a long-term adverse effect on organs and tissues, especially if not controlled well. Thus, in addition to Zithromax, I would suggest adding amoxicillin/clavulanate or a cephalosporin (Metlay et al., 2019). Your recommendations of taking probiotics after completing the antibiotic regimen and administering medications with food to reduce gastrointestinal side effects are essential. Furthermore, advising practicing proper hygiene to prevent the spread of infection was crucial. Lastly, I agree that the patient should consider restarting his anti-hypertensive therapy.
References
Gamache, J. (2020). Bacterial pneumonia. Medscape. Web.
Metlay, J. P., Waterer, G. W., Long, A. C., Anzueto, A., Brozek, J., Crothers, K., Cooley, L. A., Dean, N. C., Fine, M. J., Flanders, S. A., Griffin, M. R., Metersky, M. L., Musher, D. M., Restrepo, M. I., & Whitney, C. G. (2019). Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American thoracic society and infectious diseases society of America. American Journal of Respiratory and Critical Care Medicine, 200(7), 45–67. Web.