Visitor, a REDACTED-year-old nonsenser, has been intubated for 5 days after a stroke. They develop a temperature of 38.9 C, purulent tracheal secretions, and rising oxygen needs (PaO2/FiO2 falls from 220 to 150). WBC is 17,000/uL. CXR: new patchy right lower zone opacity with air bronchograms; yesterday’s film was clear. Tracheal aspirate: Gram-negative rods; the culture is oxidase-positive with blue-green pigment and a grape-like odor.