PNEUM

ONIA

GUILLI

AN BALI

SI

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.

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.

PNEUMONIA

RICHARD

TRACY

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

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

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

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

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

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

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.

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.

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