Question

A 38 yowf had been admitted for severe RLL pneumonia. After 5 days she left AMA because she was not allowed to smoke. At this time there was a "spot" on her RLL. She later appeared at the doctor's office without an appointment and said something was very wrong. She had flu-like symptoms which was getting worse. She could only speak in short sentences and was unable to inhale deeply. She was transported immediately to the hospital. The woman appears malnourished, poor personal hygiene and has yellow tobacco stains around her fingers. She is in moderate to severe respiratory distress.

What is your initial impression?

What test would you recommend?

Answer 1

Patient are malnourished and smoker and RLL pneumonia

Now present with severe symptoms like sepsis , patient not taken complete treatment and patient also malnourished develop sepsis like symptoms

- give broad spectrum antibiotics

Sent for blood culture and gram staining

Find appropriate bacteria and give specific antibiotic

Do chest ct rule out malignancy or lung cancer