Common cases in respiratory medicine: community acquired pneumonia
This article describes the approach to the ward round in our third patient, Mr Smith, who has community acquired pneumonia
- By: Sega Pathmanathan, Faiza Chowdhury
Arthur Smith is a 68 year old man with a history of chronic obstructive airways disease (COPD) who was brought to hospital today as an emergency. Over the past two days he has been experiencing cough and breathlessness. You review his admission notes before the post take ward round.
You review the examination section of the clerking documentation. On admission his temperature was 38.5oC, respiratory rate was 30 breaths/min, saturations 85% on 2 L of oxygen, heart rate 110 beats/min, and blood pressure 90/60 mm Hg. The base of his right lung was dull to percussion and on auscultation there was wheeze with bronchial breathing in the right base. His heart sounds were normal and his pulse was regular.
After documenting in the notes you should:
Mr Smith’s clinical signs and raised temperature at presentation suggest he has a lower respiratory tract infection. In addition, his low blood pressure and