Pneumonia Case Study: Community Acquired Pneumonia

This case study focuses on Mrs. Xyz, a 75-year-old woman diagnosed with community-acquired pneumonia (CAP) and admitted to the ICU due to underlying COPD and old age. The paper details her symptoms, including shortness of breath, fatigue, and white-grey sputum, alongside her medical history. It explores the physiological and pathophysiological aspects of CAP, including the impact of sepsis and respiratory failure. The analysis covers diagnostic methods like chest x-rays and CT scans, treatment strategies involving antibiotics, and supportive care. The study emphasizes the challenges in preventing pneumonia and the importance of early diagnosis and intervention, highlighting the vulnerability of elderly patients and the need for improved diagnostic tools and effective antimicrobial treatments. The case also discusses the absence of identified bacteria, the need for modern laboratory approaches and the importance of vaccination to prevent the spread of pneumonia.

Running head: CASE STUDY: PNEUMONIA 0
CASE STUDY: PNEUMONIA
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Case Study: Pneumonia
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CASE STUDY: PNEUMONIA 1
Case Study: Pneumonia
Pneumonia is termed as a possibly fatal inflammation and infection of the lower
respiratory tract that is often caused by the inhaled viruses and bacteria that contain both
elements of (Streptococcus pneumonia). This type of infection is regularly featured with
shortness of breath, high fever, sharp chest pain, rapid breathing, and productive cough that is
accompanied by thick phlegm (Marchello et al., 2016, 552-556). Pneumonia can be
categorized into two; thus pneumonia that develops outside the hospital environments which
is known as community-acquired pneumonia. On the other hand, pneumonia that emerges
after admission to the hospital or 48 hours later is referred to as hospital-acquired pneumonia
or nosocomial. The focus of the study is affiliated with Mrs. Xyz who has been diagnosed on
the ICU with community-acquired pneumonia (CAP) (Sharma et al., 2017, 49). This paper
will begin by the outline of her condition that comprises of a summary of her symptoms and
the assessment of the pertinent history of her situation. Moreover, it will demonstrate the
affiliation amid physiology, anatomy and the pathophysiological elements that are linked to
CAP for proper diagnosis on the affected patient since it is vital health concern (Troy et al.,
2016, 1005).
The hospitalization of elderly patients with CAP has been a considerable burden to the
Australian community since it is a critical condition that requires immediate health care
attention (Almatar et al., 2015, 259- 266). According to Mrs. Xyz she became vulnerable to
the infection because of underlying COPD and her old age. Confusion and fatigue are the
symptoms that are often presented from elderly patients like Mrs. Xyz. Fever symptoms that
are usually evident in pneumonia were not identified in her; thus it replicates an inadequate
immune response due to her age and the infection. She signified frequent and severe
complications related to pneumonia. A fall in the blood pressure or shock was resulted due to
the overwhelming reaction due to the sepsis-like picture. Respiratory failure and sepsis are

CASE STUDY: PNEUMONIA 2
the core impacts of death amid the pneumonia patients (Saukkoriipi et al., 2016, 552-556).
The other common complications that are evident constitute of the low oxygen levels and
fluid collection around the lungs.
CAP is a potentially severe and frequent infection that is affiliated with mortality and
morbidity (Grosso, Famiglietti, and Luna, 2015, 117). Etiology microorganisms are often
identified in the majority of the pneumonia cases. Therefore, the majority of the bacteria can
lead to pneumonia, and the infection of the lungs may lead to primary and secondary
infections (Musher et al., 2013, 11-13). The most common cause is the Streptococcus
pneumonia, and this chronic infection often affects the elderly people due to their weak
immune system (Bhuiyan et al., 2018, 14). Bacteria may not be available due to the
administration of antibiotics that suppresses their growth or at the moment when the blood
cultures are drawn. This trend is common among pneumonia patients.
A 75 -year old woman who will be referred to as Mrs. Xyz complained of shortness of
breath accompanied with fatigue and white grey sputum due to her past smoking history that
is affiliated with the Chronic Obstructive Pulmonary Disease (COPD) (Vliegenthart, 2018,
19). During her arrival time to the hospital, she had no chest pain or fever. In addition, she
was admitted to the ICU to examine her condition. It was found that she had low blood
oxygen levels, low blood pressure, elevated white blood cells count and anew shadow on the
chest x-ray image on her right lung. This sign and symptoms led to the confirmation that she
was diagnosed with pneumonia. This led to her admission with the diagnosis of sepsis and
community-acquired pneumonia. Sepsis is termed as an infection that has spread throughout
the entire body via the bloodstream.
According to Mrs Xyz case study, we find out that it is essential to investigate the history
of the patients diagnosed with pneumonia. Therefore physical examination and combination
of Mrs. Xyz history are beneficial since it aided to diagnose her pneumonic condition. The

CASE STUDY: PNEUMONIA 3
specialist found it challenging to determine the symptoms in Mrs. Xyz because they were not
visible. The elderly people at times may be infected with pneumonia without the symptoms
like the fever, cough and breathless showing up (Menzies, Jardine, and McIntyre, 2015, p.927
-933).
As per Mrs Xyz, she was treated with intravenous fluids, antibiotics, blood pressure
support mechanism, and oxygen via a face mask. Despite her condition improving she
underwent computed tomography (CT) scan that displayed an extensive collection of fluid on
her right lung. The appropriate medical procedure that was conducted in regards to that
situation was by the use of the two needle drainage procedure. The method was beneficial
because it led to the improvement of her oxygen requirement and the shortness of breath.
After two weeks, she completed her diagnosis and had to depart from the hospital. Mrs. Xyz
left the hospital setting without any bacteria identification in cultures of her blood, sputum or
the fluid around the lungs.
In regards to Mrs Xyz case study analysis it is evident that there is no efficient prevention
mechanism of pneumonia. However, numerous strategies can be established to mitigate the
impact of the condition (Waterer and Bennett, 2015, 219). These measures constitute to avoid
smoking; dental hygiene and adequate nutrition are factors that are associated with a healthy
lifestyle; hence it will reduce the chances of an individual being affected with pneumonia
(World Health Organization, 2016, 98).
Chest x- ray is regarded as the most appropriate test that is utilized in diagnosing
pneumonia and it significant for it to be performed to all the patients that have been supposed
to be having pneumonia. Thus an x-ray was conducted on Mrs. Xyz lungs and findings
constitutes of the interstitial infiltrates and patchy alveolar. Therefore CT is not the initial
step recommended being performed for a suspected pneumonic patient.

CASE STUDY: PNEUMONIA 4
On the other hand, the patients who are often suspected of pneumonia in primary care unit
are often put under empirical antibiotic therapy (Wunderink and Yin, 2016, 819). When the
body of the patients responds to antibiotics therapy, there will not be the need to use
microbiological testing.
Organ failure can be impacted when the pneumonic bacteria penetrate the bloodstream and
spread the disease to other vital organs. When the pneumonic condition of a patient has been
examined to be chronic due to difficulty in breathing, there is a need for hospitalization just
as the case scenario of Mrs. Xyz. The patient will have to use a breathing machine as the lung
recovers (Hurley, 2016, 577). On the other hand, pneumonia may propagate the build-up of
the fluid accumulation around the lungs. In the situation when the lung fluid becomes
infected, it is vital for it to be removed through surgery or drained by the use of the chest
tubes. The situation was witnessed in Mrs. Xyz case study when she was hospitalized since
fluids had accumulated around her right lung. The fluid had to be extracted by the use of
tubes for her to recover.
According to Mrs Xyz, her pneumonic condition is based on the history of abnormal
breath sounds, typical symptoms that could be heard with the use of chest radiographs that
display the feature shadows, the use of the stethoscope and at times through laboratory tests.
The disease was identified to be pneumonia, and it was critical to determine its severity for
proper assumptions on whether the patient is going to be admitted to the hospital. Due to the
chronic situation that Mrs. Xyz was undergoing, she had to be placed under the ICU. In other
cases scenarios where the severity of the infection is mild, the patients are often treated as
out-patients by through administering of the fluids and antibiotics. This type of mechanism is
referred to as "walking pneumonia."
In regards to Mrs Xyz, the microbe that was responsible for her pneumonic condition was
unknown since it is difficult to identify. However, antibacterial agents were designated to

CASE STUDY: PNEUMONIA 5
recuperate the most likely culprit. Majority of the viral causes of pneumonia lack efficient
drug treatments however the patients often recover without any long term consequences
(Montalto et al., 2015, 441-442).
The cough reflex, sticky mucus layer lining the airways, the structure of the upper airway,
hair-like cilia that propel mucus upwards are physical mechanisms that regulate the microbes
to reach the alveoli. Therefore, reducing the spread of pneumonia that could have been as a
result of inhalation of the microbes.
The proportion that requires hospitalization as a result of pneumonia is increasing due to
the aged population that is growing rapidly with numerous vulnerabilities (Jain et al., 2015,
415-427). As per, Mrs Xyz she had to be hospitalized because they have been a developing
problem where the pneumonic microbes are resistant to antibiotics. A factor that leads to the
resistance of the antibiotics is the inappropriate use such as for common colds.
Pneumonia is an infection that can affect any individual; however, there are two groups of
people that are at high risk of being affected by pneumonia. These include the aged people
between the age of 65 years and the children that range within two years (Earle and Williams,
2016, 9). In addition, they are other factors that propagate the pneumonia infection. An
individual may be at high risk of acquiring pneumonia in the ICU especially when the patient
is under the breathing machine. This because pneumonia is transmitted during the inhalation
process; thus the airborne microbes from the infected end being inhaled by another
individual. In addition, the hospitalized based pneumonia is impacted by the majority of the
bacteria that are resistant such as the Klebsiella pneumonia, Escherichia coli, Staphylococcus
aureus, and Pseudomonas aeruginosa.
The individuals with the complicated immune system are vulnerable to pneumonia due to
the opportunistic microbes that constitute of the viruses, fungi, and bacteria (Siow et al.,
2016, 276). A typical example is Mrs. Xyz whose immune system had been weakened as a

CASE STUDY: PNEUMONIA 6
result of smoking and old age thus making her body to be susceptible to pneumonia. Smoking
harms the body since it weakness the natural defense mechanism of the body allowing the
viral and bacterial microbes of pneumonia to penetrate the immune system of the body (Jain,
2017, 1-9).
It is difficult to treat pneumonia; thus living a healthy life can help to reduce the chances
of being exposed to the microbes (World Health Organization, 2015, 45). Pneumonia has
been one of the most significant challenges in the past; thus it is essential to reduce its burden
on aged people like Mrs. Xyz (Trad and Baisch, 2017, 120-124). On this note, there is a need
for the development of modern laboratory approaches that have the potential of identifying
the causative microbe of pneumonia (Jain and Pavia, 2016). This will enable the physicians to
be able to recognize the causative microbe and select the appropriate antimicrobial drug that
facilitates the treatment of pneumonia. A vivid example was evident during the Mrs. Xyz
case study since the physicians had difficulty in administering medication because they
lacked sufficient machinery to identify causative microbe.
Effective antibiotics need to be manufactured against the microbes since they are recently
unavailable. The antibiotics that are present have at times failed to be effective due to the
resistance ability of the pneumonic microbes. This has been evidenced because the
outpatients often complete the doses of the drug that they prescribed without complete
healing. In addition, the current vaccines need to be enhanced too by developing new
vaccines (Bruhn et al., 2017, 1524-1529). This is because the old microbes progressively
change and new ones erupt. Thus the development of new antibiotics alone will not be
sufficient due to the resistance of the microbes to antibiotics.

CASE STUDY: PNEUMONIA 7
In conclusion, it is difficult to treat pneumonia; thus living a healthy life can help to reduce
the chances of being exposed to the microbes (World Health Organization, 2015, 45). In
regards to Mrs. Xyz, Pneumonia has been one of the most significant challenges in the past;
thus it is essential to reduce its burden on aged people (Trad and Baisch, 2017, 120-124). On
this note, there is a need for the development of modern laboratory approaches that have the
potential of identifying the causative microbe of pneumonia (Jain and Pavia, 2016). This will
enable the physicians to be able to recognize the causative microbe and select the appropriate
antimicrobial drug that facilitates the treatment of pneumonia. A vivid example was evident
during the Mrs. Xyz case study since the physicians had difficulty in administering
medication because they lacked sufficient machinery to identify causative microbe.
Moreover, it is evident that the risk of acquiring pneumonia is affiliated to factors such as
age, disability, and comorbidity (Mathot et al., 2015, 1014). It is therefore appropriate
prevention measure of pneumonia need to be encouraged and established. Thus it is
significant for the people to practise cough etiquette, smoking cessation, reduce alcohol
intake, maintain healthy nutrition, hand hygiene and undertake regular physical activities
(Menzies, Jardine, and McIntyre, 2015, 927). The preventive measures that need to be
adopted comprise of the pneumococcal vaccination and influenza (Sabapathy et al., 2014,
927 -933).

CASE STUDY: PNEUMONIA 8
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