A 20-year-old college student presents with a 3-day history of cough, fever, malaise, and headache. On examination, he is febrile to 101°F and he has crackles in the right-lower lung field.
Presence of bullous myringitis on ear examination is not a common sign, but it suggests infection with Mycoplasma pneumoniae. Although most patients infected with M pneumoniae and Chlamydophila pneumoniae have relatively mild pneumonia, some will present with severe pneumonia requiring hospitalization or even ICU admission.
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