65 year old female

Presenting Complaint: sob at rest, Lethargy, fever, cough ( yellow, green sputum) Loss of Appetite. Dysphagia ( solids and liquid)

Hopc: 2 weeks ago, visited G.p, who prescribed oral antibiotics, cefalaxin. Diarhoea started 2 weeks after staring antibiotics. No improvement in symptoms. Changed to bloody diarrhoea 2 days ago. Weight loss started 2 weeks ago. ( lost half a stone) Pmx; ca cervix (clear) bowel obstruction (2006) reflux oseophagitis Drug history: F/h: brother has type 1 diabetes Obs stable

Physical examination: no clubbing, no lymphanedopathy. Cvs: s1, s2, 0. Increased vocal resonance, and course crackles ob right upper zone. Abdomen: snt. No organmegaly. No masses. Pr examination. Anal tags, empty rectum. No blood

Plan Start on Clarithyrmicin, and tazocin iv Sputum for culture and afb Iv saline , then n saline with potassium added in Respiratory review