This chest x-ray shows an ill-defined, patchy opacity in the left middle and left lower zones. Incomplete consolidation with air bronchogram is seen. The left hea border is clear, but the silhouette of the left diaphragm is lost. This is consistent with the left lower pneumonia. This patient with chronic obstructive pulmonary disease has left lower lobe pneumonia. The clinical history suggests that the patient improved on the fouh hospital day of treatment. Chest x-ray improvement usually lags behind and does not temporally correspond with clinical change. In this case the patient is improving and therefore the best option is to discharge the patient on continued antibiotics. There is no indication for either deferring the discharge or resuming IV antibiotics on the basis of a nonresolving x-ray at this stage. Bronchoscopy for drainage would not be indicated, and obtaining a CT scan would not alter the treatment or management plan at this stage.