Question:
A 68-year-old male presents with cough with sputum and bronchial sounds. RR-20/min, urea-44mg/dl, BP-110/70mmHg. What is the next step in management?
A 68-year-old male presents with cough with sputum and bronchial sounds. RR-20/min, urea-44mg/dl, BP-110/70mmHg. What is the next step in management?
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Calculate the CURB-65 score using the given parameters to determine the appropriate level of care.
Updated On: Jun 23, 2026
- Home Rx
- Admit in ICU without MV
- Admit in ICU with MV
- Room admission
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The Correct Option is D
Solution and Explanation
Step 1: Identify the condition.
The clinical picture - cough with sputum production, bronchial breath sounds, consolidation - is consistent with Community-Acquired Pneumonia (CAP).
Step 2: Apply CURB-65 scoring to determine severity.
CURB-65 is the standard tool for assessing CAP severity and guiding site-of-care decisions. Each criterion scores 1 point:
Total CURB-65 score = 2
Step 3: Interpret CURB-65 score.
Conclusion: CURB-65 score of 2 indicates moderate severity - the patient requires room (ward) admission, not home treatment or ICU.
The clinical picture - cough with sputum production, bronchial breath sounds, consolidation - is consistent with Community-Acquired Pneumonia (CAP).
Step 2: Apply CURB-65 scoring to determine severity.
CURB-65 is the standard tool for assessing CAP severity and guiding site-of-care decisions. Each criterion scores 1 point:
- C - Confusion: Not mentioned = 0
- U - Urea >19 mg/dL: Urea = 44 mg/dL > 19 mg/dL = 1
- R - Respiratory rate ≥30/min: RR = 20/min < 30 = 0
- B - BP <90 systolic or ≤60 diastolic: BP = 110/70 mmHg, systolic > 90 = 0
- 65 - Age ≥65 years: Age = 68 years = 1
Total CURB-65 score = 2
Step 3: Interpret CURB-65 score.
- Score 0-1: Low risk (1.5% mortality) - Outpatient/Home treatment
- Score 2: Moderate risk (9.2% mortality) - Inpatient (Room) admission
- Score ≥3: High risk (22% mortality) - ICU admission
Conclusion: CURB-65 score of 2 indicates moderate severity - the patient requires room (ward) admission, not home treatment or ICU.
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