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Community-Acquired Pneumonia Management
Case Study: Respiratory Infection
Patient Information:
• Name: Sarah Smith
• Age: 25
• Gender: Female
• Occupation: Teacher
• Medical History: No significant medical history reported.
Presenting Complaint: Sarah Smith presents to the clinic with complaints of cough, fever, and
difficulty breathing for the past week. She reports a productive cough with yellowish-green
sputum and chest tightness.
Physical Examination Findings:
• Vital Signs: BP 110/70 mmHg, HR 90 bpm, RR 20 breaths/min, Temp 101.2°F
• General: Alert and oriented, appears ill
• Respiratory: Decreased breath sounds and crackles heard bilaterally on auscultation
• Cardiovascular: Regular rhythm, no murmurs or abnormal sounds
• Abdomen: Soft, non-tender, no organomegaly
• Neurological: Intact cranial nerves, normal motor and sensory functions
Laboratory Investigations:
• Complete Blood Count (CBC): Elevated white blood cell count (WBC) with left shift
• Chest X-ray: Infiltrates in bilateral lower lung fields consistent with pneumonia
•
Diagnosis: Sarah Smith is diagnosed with community-acquired pneumonia based on her clinical
presentation, physical examination findings, and radiological evidence.
Questions for Students:
1. What are the common signs and symptoms of community-acquired pneumonia?
2. Describe the typical findings on physical examination and chest X-ray in patients with
pneumonia.
3. What are the most common pathogens causing community-acquired pneumonia, and
how would you choose empirical antibiotic therapy in this patient?
4. Discuss the management of community-acquired pneumonia, including non-
pharmacological measures and potential complications to monitor for.
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Community-Acquired Pneumonia Management
1. Common Signs and Symptoms of Community-Acquired Pneumonia
Core symptoms include:
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Fever (often >100.4°F / 38°C)
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Cough (often productive with yellow/green sputum)
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Dyspnea (shortness of breath or difficulty breathing)
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Chest pain (pleuritic—sharp, worse with deep breaths or cough)
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Fatigue and malaise
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Sweating and chills
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Tachypnea (elevated respiratory rate)
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Tachycardia
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In severe cases: confusion, especially in older adults
Sarah’s symptoms (productive cough, fever, chest tightness, shortness of breath) are consistent with this clinical picture.
2. Typical Findings on Physical Examination and Chest X-ray in Pneumonia
Physical Examination Findings:
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Fever and signs of systemic illness (e.g., appearing ill)
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Crackles/rales on auscultation (from alveolar fluid)
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Dullness to percussion (if consolidation is present)
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Bronchial breath sounds
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Decreased breath sounds (due to consolidation or effusion)
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Egophony or whispered pectoriloquy (enhanced vocal resonance)
Chest X-ray Findings:
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Localized or diffuse infiltrates (depending on lobar vs bronchopneumonia)
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Consolidation, especially in lower lobes
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May see air bronchograms in affected areas
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In Sarah’s case: bilateral lower lobe infiltrates → consistent with typical pneumonia pattern
3. Most Common Pathogens and Empirical Antibiotic Therapy
Most common pathogens in..