Mr. Wright is a 74-year-old male that was brought to the Emergency Room (ER) thi

Question

Mr. Wright is a 74-year-old male that was brought to the Emergency Room (ER) this morning by his wife. Mr. Wright stated that he has been experiencing some shortness of breath for the past 2 days, and that it continued to get worse. He reported a productive cough with clear mucus. Mr. Wright's wife stated that she had noticed him having trouble walking to the bathroom for the past day, and that he seemed to be getting weaker. His wife also stated that she felt like Mr. Wright looked pale and felt warm to touch. Mr. Wright's Past Medical History (PMH) includes: COPD (Chronic Obstructive Pulmonary Disease), smoker (2 packs per day) and BPH (Benign Prostatic Hyperplasia). Physical assessment findings: Vitals: temp- 100.0, pulse- 88, respiratory rate- 28, blood pressure- 148/90, Oxygen saturation, 89% on room air Use of accessory muscles with breathing Pallor (pale skin) Generalized weakness Productive cough Decreased breath sounds Rhonchi (rattling lung sounds) present upon auscultation Required one person to assist with ambulation to restroom 3L of oxygen via nasal cannula was applied The ER doctor ordered a chest x-ray, pulmonary function test (PFT), Albuterol treatments Prednisone, Proscar, Coreg and a Nicotine Patch. Mr. Wright was admitted to the floor with a diagnosis of pneumonia.

Explanation / Answer

Pneumonia is an infection in one or both lungs. It can be caused by bacteria, viruses, or fungi. Bacterial pneumonia is the most common type in adults.

Pneumonia causes inflammation in the air sacs in your lungs, which are called alveoli. The alveoli fill with fluid or pus, making it difficult to breathe.

If your symptoms are very severe or you have other health problems, you may need to be hospitalized. At the hospital, doctors can keep track of your heart rate, temperature, and breathing. Treatment may include:

Pneumonia can be classified into-

Bacterial pneumonia: The most common cause of bacterial pneumonia is Streptococcus pneumoniae. Chlamydophila pneumonia and Legionella pneumophila can also cause bacterial pneumonia.

Viral pneumonia: Respiratory viruses are often the cause of pneumonia, especially in young children and older people. Viral pneumonia is usually not serious and lasts for a shorter time than bacterial pneumonia.

Mycoplasma pneumonia: Mycoplasma organisms are not viruses or bacteria, but they have traits common to both. Mycoplasmas generally cause mild cases of pneumonia, most often in older children and young adults.

Fungal pneumonia: Fungi from soil or bird droppings can cause pneumonia in people who inhale large amounts of the organisms. They can also cause pneumonia in people with chronic diseases or weakened immune systems.

One kind of fungal pneumonia is called Pneumocystis jirovecii pneumonia (PCP). This condition generally affects people with weakened immune systems, such as those with AIDS. In fact, PCP can be one of the first signs of infection with AIDS.

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