Community Acquired Pneumonia


Step 1: View clinicals

A 60 year old woman presents with dyspnea and a cough productive of yellow-green sputum for 3 days. During the preceding 2 weeks, she had also experienced a non-productive cough and myalgia. There was no history of hemoptysis or fever. She was diagnosed with diabetes mellitus 3 years ago, which is well controlled on diet alone. She is a heavy smoker, with a smoking history of 30 pack years. She currently works as a volunteer in a homeless shelter.

Step 2: Order all relevant investigations

Full Blood Count

WBC: 10,900/mm3 N: 78% L: 22% Hb: 13 g/dl Plt: 213,000/mm3

Chest X-Ray

There is a heterogeneous opacity of the right lower zone. Air bronchograms are present.

Renal Function Tests

S. Creatinine: 0.7 mg/dl (0.5 - 1.5) Blood Urea: 15 mg/dl (0 - 50)

Sputum for AFB

No acid-fast bacilli are detected.

Step 3: Select appropriate management

Nebulize with Salbutamol
Steam Inhalation

Score: ★★☆