Clinical Case Database / Category: Patient Management

A community-acquired pneumonia in a patient with chronic lung disease requiring intensive care (level 3) admission

Publication details

Jahnavi Dabali MB, BS, MD, Rob Townsend MBCHB, MSc, DTMH, FRCPath
Foundation Years Journal, volume 4, issue 2, p.32 (123Doc Education, London, February 2010)

Abstract

We report a case of community-acquired pneumonia in a 73-year-old Caucasian lady with a background history of chronic airways disease (COPD) who was admitted in a state of septic shock and a CURB-651 score of 5 which needed level 3 (ITU) treatment and mechanical ventilation. Clinical examination and X-ray findings suggested bilateral consolidation complicated by a pleural effusion. Sputum and broncho-alveolar lavage (BAL) cultures grew Streptococcus pneumoniae and Enterobacter cloacae. She failed to respond to initial empirical antimicrobial treatment with co-amoxyclav and clarythromycin but responded well to meropenem.

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Authors

Jahnavi Dabali MB, BS, MD

Specialist Registrar
Department of Microbiology
Sheffield Teaching Hospitals NHS Foundation Trust
Northern General Hospital
Herries Road
Sheffield S5 7AU

Rob Townsend MBCHB, MSc, DTMH, FRCPath

Consultant Microbiologist
Department of Microbiology
Sheffield Teaching Hospitals NHS Foundation Trust
Northern General Hospital
Herries Road
Sheffield S5 7AU
rob.townsend@sth.nhs.uk

References

1. Lim WS, van der Eerden MM, et al. (2003) Defining community-acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax, 58:377–382.
2. Kollef, et al. (1999) Chest, 115:462–474.

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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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