Question

Case Study 8

Game warden Brian has not been feeling well for the past two weeks. He has congestion in his lungs and has been very tired. He finally decided to go to the doctor when his temperature reached 101oF. He is feeling so feverish that he could not work. Rifle deer season is just around the corner, so he needs to get over this chest infection. His doctor gave him some oral amoxicillin, which he took faithfully for 10 days until it was complete. He is still feeling ill. Brian goes back to the doctor, who finds Brian basically unchanged from his appointment nearly two weeks ago. The doctor begins to suspect that Brian does not have a bacterial infection. In order to make his diagnosis, the doctor asks Brian a few more questions.

Brian is 40 years old and has been a game warden in Ohio for 12 years. He has been very busy at work since hunting season began just over a month ago. He is married with two boys, who he has taken hunting and fishing within the last month. In fact, they had gone to hunt Oryx in New Mexico a short while before Brian began to get sick. They live on a small acreage, but only have one hunting dog and no livestock. Brian has had basically good health other than nagging knee pain from an old sports injury, so other than getting the occasional steroid shot in the knee, he has only been in to see the doctor for yearly checkups and vaccinations…until now.

1.   What is your tentative diagnosis?

2.   What tests should be run to identify his infection? What will you be looking for?

3.   What treatment would you provide Brian?

4.   What is the likely outcome of this infection?

Answer 1

1. Pneumonia

2. Chest x ray

Lung function test

Blood studies

3.

• Drug therapy

1. Antibiotics
2. Bronchodilators.
3. Corticosteroid
4. Non steroid anti inflammatory drugs

• Promote rest
• Anti pyretics to reduce fever
• Maintain airway and breathing
• Health education breathing exercises

4. Patient will maintain normal breathing pattern