A 55-year-old male with a history of COPD presents with increased dyspnea, productive cough, and purulent sputum. He reports increased use of his rescue inhaler with minimal relief. On examination, there are decreased breath sounds and wheezing. What is your working diagnosis and next steps?
In a patient with COPD presenting with increased shortness of breath, productive cough, and purulent sputum, a COPD exacerbation secondary to pneumonia should be suspected. The next steps should include a chest X-ray to evaluate for the presence of pneumonia, complete blood count, and potentially sputum cultures. Treatment should involve antibiotics, bronchodilators, and corticosteroids, and this patient may require hospitalization given the severity of his symptoms.