Diagnosis
The diagnosis that can be made from the symptoms of the patient is community-acquired pneumonia (CAP). CAP is a severe disease of the lungs that occurs in people who do not have regular access to health care services. The risk factors of CAP include old age and medical comorbidities. CAP has been defined as comprising of chest pain, productive cough, fatigue, shortness of breath, fever, sweating and shaking chills (Musher, & Thorner, 2014). Bacteria such as Streptococcus pneumonia, atypical organisms such as Mycoplasma pneumonia, fungi, and viruses may cause pneumonia.
Gram Staining
The sputum taken from the lungs after a deep cough is analyzed to determine the cause of infection. Gram stain pinpoints the immediate indicator of the likely pathogen. The knowledge of the pathogen has a major effect on the patient’s care and significant in determining the treatment guidelines (Schmitt, 2010).
Pulse Oximetry
This test measures the level of oxygen in the patient’s blood (National Institute of Health, 2016). The abscesses produced by pneumonia can prevent the lungs oxygenating the blood.
Procalcitonin test
This test helps in monitoring the response to treatments of the community acquired pneumonia and reduces the exposure to antibiotics without compromising the patient’s safety (Viera, 2016).
Complete Blood Count (CBC)
CBC a type of blood test that helps to determine if the patient’s immune system is fighting the infection (Schmitt, 2010). Information about the circulating cells provides significant clues about the health of the body. Results from the CBC can confirm the existence of a health condition or rule out a disease.
Blood Culture
A blood culture test helps to identify the causative bacterial pathogens in the bloodstream (National Institute of Health, 2016). A positive test guides the doctor on the appropriate treatment regimen to prescribe for the patient.
Chest Radiograph
This test is recommended for the routine assessment of the patients who are suspected to have to have pneumonia. It can indicate a diagnosis and helps in distinguishing community-acquired pneumonia from diseases that exhibit similar symptoms of fever and cough such as acute bronchitis. The radiographs provide beneficial information relating to the infective pathogen, prognosis, and related conditions (Mandell et al., 2007; Schmitt, 2010).
Treatment
Sanchez et al. (2003) report that a composite of beta-lactam and a macrolide can enhance the treatment outcomes for the old patients with CAP. These antimicrobial regimens are administered to the patient with moderate uncomplicated CAP for seven days. A treatment period of 7-10 days is proposed for patients with severely acute unclear pneumonia (Pinzone et al., 2014). Nonetheless, the treatment period may be extended to 14 or 21 days upon confirmation that the pathogen is S. aureus, or Gram-negative enteric bacilli pneumonia. A meta-analysis reported by Pinzone et al. (2014) indicated that azithromycin is the most effective macrolide for short-term use for CAP therapy. The short-term treatment minimizes the risk of bacterial resistance, improves patient compliance, and decreases the adverse effects on the patients. Tigecycline also provides favorable clinical outcomes for patients with bacterial CAP (Donovan, 2015). Tigecycline is given intravenously for 7 to 14 days.
References
Donovan, F. (2015). Community-Acquired Pneumonia Empiric Therapy: Empiric Therapy Regimens. Emedicine.medscape.com. Retrieved 19 January 2017, from http://emedicine.medscape.com/article/2011819-overview
Mandell, L. A., Wunderink, R. G., Anzueto, A., Bartlett, J. G., Campbell, G. D., Dean, N. C., & Torres, A. (2007). Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults. Clinical Infectious Diseases, 44, S27-72.
Musher, D. & Thorner, A. (2014). Community-Acquired Pneumonia — NEJM. New England Journal of Medicine. Retrieved 19 January 2017, from http://www.nejm.org/doi/full/10.1056/NEJMra1312885
National Institute of Health. (2016). Diagnosis. Retrieved 19 January 2017, from https://www.nhlbi.nih.gov/health/health-topics/topics/pnu/diagnosis
Pinzone, M. R., Cacopardo, B., Abbo, L., & Nunnari, G. (2014). Duration of Antimicrobial Therapy in Community-Acquired Pneumonia: Less Is More. The Scientific World Journal, 2014, 759138. http://doi.org/10.1155/2014/759138
Sanchez, F., Mensa, J., Martinez, J. A., Garcia, E., Marco, F., González, J., & Torres, A. (2003). Is azithromycin the first-choice macrolide for the treatment of community-acquired pneumonia? Clinical infectious diseases, 36(10), 1239-1245.
Schmitt, S. (2010). Community-Acquired Pneumonia. Retrieved 19 January 2017, from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/infectious-disease/community-acquired-pneumonia/
Viera, A. (2016). Community-Acquired Pneumonia in Adults: Diagnosis and Management - American Family Physician. Retrieved 19 January 2017, from http://www.aafp.org/afp/2016/1101/p698.html
