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A Case Study: Pneumonia

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DOI: 10.4172/2329-6879.1000242

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 Occupational Medicine & Health
Affairs Zafar, Occup Med Health Aff 2016, 4:4
DOI: 10.4172/2329-6879.1000242

Case Report Open Access

A Case Study: Pneumonia

Muhammad Zeeshan Zafar*
Faculty of Pharmacy, University of Sargodha, Pakistan
*Corresponding author: Zafar MZ, Faculty of Pharmacy, University Of Sargodha, Pakistan, Tel: 03466189496; E-mail: [email protected]
Rec date: July 8, 2016; Acc date: July 29, 2016; Pub date: August 4, 2016
Copyright: © 2016 Zafar MZ. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Pneumonia (from the Greek pneuma, “breath”) is a potentially fatal infection and inflammation of the lower
respiratory tract (i.e., bronchioles and alveoli) usually caused by inhaled bacteria and viruses has both properties
(Streptococcus pneumoniae, aka pneumococcus). The illness is frequently characterized by high fever, shortness of
breath, rapid breathing, sharp chest pain, and a productive cough with thick phlegm. Pneumonia that develops
outside the hospital setting is commonly referred to as community-acquired pneumonia. Pneumonia that develops
48 hours or later after admission to the hospital is known as nosocomial or hospital acquired pneumonia. In this case
report we review the presentation and management of pneumonia involving the respiratory system. The aim of this
report is to alert the clinicians to the potential diagnosis of pneumonia treatment. This is the case report of 3 months
old boy with Pneumonia. He was diagnosed with pneumonia. His treatment was starting and after 7 days, he
became completely recovered. For his disease diagnosis different tests are also performed.

Keywords: Community-acquired pneumonia (CAP); Pneumonia; non-typhoid Salmonella spp. Furthermore, studies of lung aspirate
Diagnosis; Drug uses; Doctors treatment; Respiratory disorders have identified Mycobacterium tuberculosis as an important cause of
pneumonia.
Introduction
Case Presentation
Community-acquired pneumonia (CAP) is a common and
potentially serious illness that is associated with morbidity and A 3 months old boy was brought to the DHQ hospital Gujranwala,
mortality. Only half of the cases had an etiology microorganism Pakistan. He presenting complains are cough, fever, dyspnea, vomiting
identified. and diarrhea from the period of last 5 days.
Dozens of types of bacteria can cause pneumonia. Bacterial He ate contaminated food and drinks few days ago so, that is the
pneumonia is caused by an infection of the lungs and may present as a main cause of this. Before to come here they also went in Ahsan
primary disease or as secondary disease in a debilitated individual or hospital Daska, Pakistan, but he did not understand a disease, he gave
following a viral upper respiratory infection, such as influenza or the him Amoxicilline 125 mg/5 ml and Dimenhydrinate 12.5 mg/4 ml
common cold. syrups.
Community-acquired pneumonia tends to be caused by different After 3 days of treatment, they came into DHQ hospital Gujranwala.
microorganisms than those infections acquired in the hospital. Other chief complaints by the patient include problem in breathing
may be due to cold feeling.
Pneumonia caused by Streptococcus pneumonia remains the most
common cause of all bacterial pneumonias. High-risk groups include His physical examination showed temperature 102⁰F. Respiratory
older adults and people with a chronic illness or compromised rate is 28 beats/min, hear crept on auscultation, he weighed 5 kg. His
immune system. This type of pneumonia is a common complication of caused of fever may be some cold exposure.
chronic cardiopulmonary disease (e.g., heart failure) or an upper
He was treated with Cefixime 100 mg/5 ml, Ibuprofen 100 mg/5 ml,
respiratory tract infection [1].
pseudoephedrine 15 mg/5 ml and Dimenhydrinate 12.5 mg/5 ml in
The knowledge of etiology of pneumonia in low and middle income DHQ hospital. Doctor advised him for laboratory tests and admitted
countries is based on two types of studies: prospective, microbiology- him in a Hospital.
based studies and vaccine trial studies, where indirect evidence of
vaccine efficacy for the prevention of pneumonia can be used to Diagnosis
estimate the disease burden of each pathogen.
CBC (Complete blood count), CXR (Chest X-Ray), Electrolyte
Prospective studies have identified Streptococcus pneumonia as the count tests are performed. CBC showed that his TLC Total leukocytes
leading cause of bacterial pneumonia among children in developing count) and lymphocytes concentrations had increased, neutrophils
countries, responsible for 30-50% of pneumonia cases. decreased.
The second most common is Haemophilus influenza type b His neutrophils concentration now 22% whose normal value is 45 to
followed by Staphylococcus aureus and Klebsiella pneumonia Other 75% and lymphocytes concentration increased whose normal value is
bacteria are Mycoplasma pneumonia and Chlamydia pneumonia, 20 to 45% (Table 1).
causing atypical pneumonia non-typable H. influenza (NTHI) and

Occup Med Health Aff, an open access journal Volume 4 • Issue 4 • 1000242
ISSN:2329-6879
Citation: Zafar MZ (2016) A Case Study: Pneumonia. Occup Med Health Aff 4: 242. doi:10.4172/2329-6879.1000242

Page 2 of 3

Test Value Units Expected value

Hb% 12.1 g/dl 14 to 24

WBC 12100 mm3 new born 5500 to 18000/cm

Platelet count 616000 mm3 150000 to 400000

Different Leucocyte count (DLC)

Neutrophils 22 % 45 to 75%

Lymphocytes 70 % 20 to 45%

Eosinophils 4 % 02 to 06%

Monocytes 4 % 02 to 10%

RBC 5.57 10>12/litre 3.5 to 5.5

MCV 79.2 F1 75 to 100

HCT 36.2 % 35 to 55

MCH 26.5 Pg 25 to 35

MCHC 33.4 g/dl 31 to 38 Figure 1: Chest X-Ray: In this a white patch seen on left side upper
lobe of lung which indicated pneumonia.
Table 1: Complete Blood Count test (CBC): It’s a hamatology report in
which values of different cells of patient’s blood compared with their
At the fifth day continuously five days treatment child become
normal values.
completely recovered and doctor discharged them at 5/10/2014.
On electrolyte counting test showed that calcium concentration
decreased which is 7.8 now its normal value is 8.5 to 10.5 (Table 2). Discussion
Community-acquired pneumonia (CAP) is a frequent cause of
Test Value Unit Expected value
hospital admission and mortality in elderly patients worldwide. The
Sodium 136 mEq/L 135……….145 clinical presentation, etiology, and outcome of community acquired
pneumonia in elderly differs from that of other population [2,3].
Potassium 4.4 mEq/L 3.8………5.0
This patient had community-acquired bacterial pneumonia on the
Calcium 7.8 mEq/L 8.5……….10.5 basis of his physical examination and chest radiograph.
The most common cause of community-acquired bacterial
Table 2: Serum Electrolyte Test: In this, values of patient serum
pneumonia is Streptococcus pneumoniae. The finding of gram-positive
elements compared with normal value. Here we conclude that Calcium
diplococci in the blood is consistent with pneumococcal disease as
concentration decreased in body.
well. Approximately 25 to 30% of patients with pneumococcal
On Chest X-Ray detected a white patch on left side upper lobe, pneumonia will have positive blood cultures. Group A streptococcus is
which indicated that pneumonia is confirmed. So when the another possible organism because it can cause bacteremic pneumonia
pneumonia is confirmed then Doctor started his actual treatment and can possibly appear as a gram-positive diplococcus. However, in a
(Figure 1). blood culture, group A streptococci are much more likely to be present
as gram-positive cocci in chains. The two streptococci are easily
distinguished by the fact that S. pneumoniae is alpha-hemolytic and
Treatment bile soluble whereas group A streptococcus is beta-hemolytic and bile
His treatment include injection Cefotaxime 250 mg intravenous insoluble but bacitracin susceptible.
B.D, injection Ampicillin 125 mg intravenous after 6 hours, given Determination of precise etiology of pneumonia is difficult due to
Nebolization with ventoline, and Oxygen now SOS, and a Panadol the lack of sensitive and specific tests. Many clinicians treat pneumonia
drops, 10 drops. His vitals were checked. empirically with minimal laboratory or radiographic evaluation and
The patient recovered slowly and after 2 days treatment Doctor thus up to 80% of non-bacterial pneumonia may be treated with
again checked him and gave him another treatment claritex drops 1/2 antibiotics. This approach is satisfactory when clinical risk is deemed
drops and Calcium 2/2. to be low [4].

At the third day of his admission in hospital Doctor checked him,

his physical examination showed now that temperature reached at
Conclusion
100⁰F, diarrhea and vomiting are also decreased. Doctor advised his Our main findings and conclusion were:
mother to continue this medication, care and feed properly.

Occup Med Health Aff, an open access journal Volume 4 • Issue 4 • 1000242
ISSN:2329-6879
Citation: Zafar MZ (2016) A Case Study: Pneumonia. Occup Med Health Aff 4: 242. doi:10.4172/2329-6879.1000242

Page 3 of 3

Community-acquired pneumonia in elderly patients is a common Antibiotics improve outcomes in those with bacterial
and serious problem encountered in clinical practice. Elderly patients pneumonia. Antibiotic choice depends initially on the characteristics
with community-acquired pneumonia have different clinical of the person affected, such as age, underlying health, and the location
presentation and higher mortality. the infection was acquired.
From this case study we conclude that main causes for pneumonia Stay away from people who have colds, the flu, or other respiratory
and what are these treatments. tract infections.
As we read that here patient is not cured after its first treatment If you haven't had measles or chickenpox or if you didn't get
because disease was not identied our main purpose is to first diagnose vaccines against these diseases, avoid people who have them.
a disease and then to start rational treatment.
Preventive measures are under observations i.e., avoid
contaminated food, drinks purified water etc.
Acknowledgment
I take this opportunity to express my profound gratitude and deep References
regards to Dr. Taha Nazir (Assistant Professor and Course Director
1. Schumann L (2006) Pneumonia. In: Copstead LEC, Banasik JL (eds.).
Microbiology & Immunology, Faculty of Pharmacy, University of Pathophysiology (3rd edn) St WHO.
Sargodha)for his exemplary guidance, monitoring and constant
2. World Health Organization (2002) Promoting rational use of medicines:
encouragement throughout the course of this case report. Also thanks core components: WHO policy perspectives of medicines. No.5. Geneva:
to the staff at the Pediatrics department at the DHQ hospital WHO.
Gujranwala. 3. World Health Organization (2009) Medicines use in primary care in
developing and transitional countries: Fact book summarizing results
Recommendations from studies reported between 1990 and 2006. Document No.
WHO/EMP/MAR/2009.3. Geneva: WHO.
Increase caretakers' recognition of pneumonia signs through 4. Levinson W (2012) LANGE: Review Of Medical Microbiology and
extensive health communication activities by strengthening the third Immunology (12th edn) (Part IX brief summaries of medical important
component of IMCI (improving family and community practices). organisms).

Occup Med Health Aff, an open access journal Volume 4 • Issue 4 • 1000242
ISSN:2329-6879

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