BRIEF OVERVIEWPneumonia is a respiratory disease in which there is an infectionin the lungs. It is often caused by micro-organisms such asviruses, bacteria, or fungi. Pneumonia causes the air sacs(alveoli) and other smaller air ways (bronchioles) in the lungs tobecome inflamed and fill with fluid. As a result, one’s lungscannot work properly, the fluid inhibit gas exchange from thealveoli to the capillaries, and thus oxygen is unable to reach theblood.
DIFFERENT TYPESThere are two different types of pneumonia. One that affects asingle lobe of the lung is called lobular pneumonia. One thataffects the bronchi and bronchioles and smaller patches aroundboth lungs is called bronchial pneumonia. In the diagrambelow, the left lung is infected with lobular pneumonia and theright lung is infected with bronchial pneumonia.
RICHARD TRACYAbout the Patient• Has pneumonia• 16 year old male• Not physically active• Moderately healthy diet (consists mainly of rice and chicken)• Drinks plenty of water• Has pets: two cats and a rabbit• Does not get proper rest – only around 6-7 hours a night• Works at a place with heavy physical labour
RICHARD TRACYMedical History• Patient catches the cold and flu often (around twice a year), mostly during the winter and early spring• Patient experiences chronic stress due to school and work• Patient takes too much Nyquil when sick, often feels drowsy, debilitated, and has low-energy• Patient’s mother is healthy• Patient’s father smokes (has been smoking for 2 years), creating an environment which makes him more prone to infection• Patient’s brother is healthy• Patient has no allergies to medications
RICHARD TRACYSymptomsThe patient has been demonstrating the following symptoms:• Coughing (has been coughing up green, yellow, and sometimes bloody mucus)• Difficulty in breathing and breathlessness (especially during/after strenuous physical activity)• Mild fever• Loss of appetite• Fatigue• Sharp pains in the chest especially when coughing
RICHARD TRACYDiagnostic Tests and ProceduresThe patient has been tested with:• Arterial blood gases (i.e. measuring how much oxygen and carbon dioxide is in the blood and also the pH level of the blood using a blood sample) to see if enough oxygen is getting into the blood from the lungs• Grams stain and culture of your sputum (i.e. the patient coughs deeply and spits any mucus into a cup and then the mucus is examined) to look for the bacteria or virus that is causing the patient’s symptoms
RICHARD TRACYDiagnostic Tests and Procedures• CT-Scans and x-rays of the chest to find infected regions of the lungs and the severity of the infection• Using a fluid sample (retrieved by placing a needle between the ribs and extracting the fluid) from the lungs to test for any disease-causing bacteria or viruses• A stethoscope was used against to detect any abnormalities (such as crackles) in the patient’s breathing
RICHARD TRACYDiagnosis: Final Results• CT-Scans and x-rays show lobular pneumonia in the top region of the patient’s right lung • Mucus and fluid samples from the patient’s lungs indicate the presence of Streptococcus pneumoniae, a bacterial form of pneumonia• Patient’s breathing was unsteady and crackled• Patient had low levels of oxygen in his blood
RICHARD TRACYTreatmentsAfter the various tests conducted on Richard Tracy, he has beendiagnosed with a case of bacterial pneumonia in his right lung.The main cause of his infection is the presence of the bacteriaStreptococcus pneumoniae and thus his treatment is thefollowing:• Antibiotic therapy (Beta-lactam (IV or IM) plus doxycycline (IV or PO). These antibiotics will kill the bacteria which are causing the excessive fluid and mucus growth in your alveoli and other air ways.The patient must also ensure he gets plenty of rest and drinkplenty of liquids. It is also advised that the patient’s father to stopsmoking for now (and hopefully forever) to aid in his recovery.
RICHARD TRACYPrognosisOnce the patient has started taking the antibiotics, it should takeno longer than 48 hours for them to start killing off the bacteria inthe lungs. The patient will start feeling better within 3-5 days aftertreatment. Pneumonia, however, can cause fatigue and tirednessfor up to six weeks, so it is important for the patient to keeptaking the medication and to keep getting plenty of rest despitemost of the symptoms going away. Eventually, the patient willreturn back to normal and will need to come back in for a finalexamination to make sure that his lungs are completely healthy.
RICHARD TRACYRecommendations for life-style changesTo prevent future cases of pneumonia, Richard Tracy shouldconsider the following:• Get more rest (8 hours of rest per day is optimal)• Eat more fruits, vegetables, and whole grains to promote overall well-being• Get your vitamins (vitamin C is great for combatting the cold and flu)• Tell your dad to find a place far away from you when he smokes, or suggest him to quit altogether• Try and find some time for moderate-intensity exercise