The document describes a case of pneumonia in a 16-year-old male named Richard Tracy. Diagnostic tests showed he had lobular pneumonia in his right lung caused by the bacteria Streptococcus pneumoniae. His treatment plan includes antibiotics and rest. With treatment, his symptoms should improve within a week but he may feel fatigued for up to 6 weeks and needs lifestyle changes to prevent future cases of pneumonia.

2. BRIEF OVERVIEW
Pneumonia is a respiratory disease in which there is an infection
in the lungs. It is often caused by micro-organisms such as
viruses, bacteria, or fungi. Pneumonia causes the air sacs
(alveoli) and other smaller air ways (bronchioles) in the lungs to
become inflamed and fill with fluid. As a result, one’s lungs
cannot work properly, the fluid inhibit gas exchange from the
alveoli to the capillaries, and thus oxygen is unable to reach the
blood.

3. DIFFERENT TYPES
There are two different types of pneumonia. One that affects a
single lobe of the lung is called lobular pneumonia. One that
affects the bronchi and bronchioles and smaller patches around
both lungs is called bronchial pneumonia. In the diagram
below, the left lung is infected with lobular pneumonia and the
right lung is infected with bronchial pneumonia.

4. PNEUMONIA

6. RICHARD TRACY
About 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

7. RICHARD TRACY
Medical 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

8. RICHARD TRACY
Symptoms
The 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

9. RICHARD TRACY
Diagnostic Tests and Procedures
The 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
• Gram's 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

10. RICHARD TRACY
Diagnostic 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

11. RICHARD TRACY
Diagnosis: 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

12. RICHARD TRACY
Treatments
After the various tests conducted on Richard Tracy, he has been
diagnosed with a case of bacterial pneumonia in his right lung.
The main cause of his infection is the presence of the bacteria
Streptococcus pneumoniae and thus his treatment is the
following:
• 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 drink
plenty of liquids. It is also advised that the patient’s father to stop
smoking for now (and hopefully forever) to aid in his recovery.

13. RICHARD TRACY
Prognosis
Once the patient has started taking the antibiotics, it should take
no longer than 48 hours for them to start killing off the bacteria in
the lungs. The patient will start feeling better within 3-5 days after
treatment. Pneumonia, however, can cause fatigue and tiredness
for up to six weeks, so it is important for the patient to keep
taking the medication and to keep getting plenty of rest despite
most of the symptoms going away. Eventually, the patient will
return back to normal and will need to come back in for a final
examination to make sure that his lungs are completely healthy.

14. RICHARD TRACY
Recommendations for life-style changes
To prevent future cases of pneumonia, Richard Tracy should
consider 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