A 52-year-old man with a history of severe low back pain is admitted to the hospital with a GI bleed

A 52-year-old man with a history of severe low back pain is
admitted to the hospital with a GI bleed in the setting of excessive NSAID use.
He has not seen a doctor in 5 years. His presenting symptoms include epigastric
abdominal pain, black stools, and dizziness with standing. Admission hemoglobin
is 5.2 g/dl and white blood count (WBC) count is 6.2 × 109 . He is
transfused red blood cells (RBCs) and undergoes upper GI endoscopy, which
reveals a large bleeding duodenal ulcer. Three days into his admission, the
patient develops a fever to 40.2°C, shortness of breath, and cough. Laboratory
testing reveals a WBC count of 16.8 × 109 . Chest radiography
reveals a patchy infiltrate in the right lower lobe. What type of pneumonia
does this patient have? How might this infection have developed?

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