Pulmonary Diseases
 
Introduction
  Pneumonia
  Bronchiectasis
  Asthma
  Pleural Effusions
  Prevention
Cases
  Dyspnea
  Cough & Fever
  Cough & Diarrhea
  Productive Cough
  Cough, Weight Loss
 
 
 

 

The following day she is still febrile with a temp of 39°C and right-sided pleuritic pain.

  • Her chest X-ray is stacked at the bedside, along with those of the previous three occupants of her bed.
  • Her hemogram was either not drawn or was lost, in any event there are no results.
  • Lucy appears to have a community- acquired pneumonia. The team decides to:
    • Send a sputum for AFB,
    • Draw a hemogram and
    • Continue penicillin treatment.
  • The hemogram eventually is done:
    • Elevated WBC with left shift.
  • Sputum for AFB is negative X 2.

Lucy does have a community-acquired pneumonia.
  • After three days of treatment, her pleuritic pain and tachycardia are improved.
  • Fortunately, PNC resistant S. pneumoniae has not been found in Eldoret.
  • If a patient does not improve after a few days of treatment, one might consider
    • Legionella or H. influenza
    • Differential should also include TB and PCP (PCP can present like this particularly if the person is on Septrin for prophylaxis when it manifests).

A woman with cough and chronic diarrhea comes to the clinic.
 
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