A 35-year-old woman with a history of smoking presents with fever, productive cough, pleuritic chest pain, and a new-onset rash on her face and trunk. On examination, there is a maculopapular rash on her cheeks and upper trunk, and decreased breath sounds over the right lower lung field. Chest X-ray reveals a right lower lobe consolidation. What is the most likely diagnosis? A. Acute bacterial pneumonia B. Tuberculosis C. Pneumocystis jirovecii pneumonia (PCP) D. Viral pneumonia E. Atypical pneumonia (e.g., Mycoplasma pneumoniae) Answer: E. Atypical pneumonia (e.g., Mycoplasma pneumoniae) Explanation: This patient's presentation of fever, productive cough, pleuritic chest pain, and a maculopapular rash on her face and trunk is suggestive of atypical pneumonia, most likely caused by Mycoplasma pneumoniae. The presence of a maculopapular rash is a characteristic feature. Acute bacterial pneumonia would not typically present with this type of rash. Tuberculosis typically presents differently. PCP is more common in immunocompromised individuals. Viral pneumonia may present with a cough and fever but not necessarily a rash.
