Hospital-acquired and ventilator-associated pneumonia Quiz: Ace Your Exams

A 46-year-old man is admitted to the hospital for small bowel obstruction. He is treated with nasogastric tube decompression, intravenous fluids, and pain control. He improves quickly and the enteric tube is removed after three days. He is able to tolerate a liquid diet and has no nausea or vomiting. The following day, the patient develops a new, productive cough, right-sided pleuritic chest pain, and chills. Temperature is 38.0°C (100.4°F), blood pressure is 120/80 mmHg, pulse is 110/min, respiratory rate is 18/min, and oxygen saturation is 90% on room air. Based on clinical symptoms and physical examination, a chest x-ray is performed, showing right middle lobe consolidation. Images are shown below. Given this patient’s most likely diagnosis, which of the following physical examination findings is likely present?


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