A 62-year-old man with a history of chronic obstructive pulmonary disease presents with cough, headache, dyspnea, and watery diarrhea that started 6 days ago. He was seen at a local urgent care 4 days ago and prescribed amoxicillin-clavulanate without improvement. He is ill appearing with a fever of 38.7°C and inspiratory rales on auscultation. Which of the following results would be most consistent with his diagnosis?
Right upper lobe infiltrate with bulging fissure on chest X-ray
Serum potassium 6 mEq/L
Serum sodium 128 mEq/L
Sputum gram stain with gram positive cocci in pairs
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