Pneumonia Galore

Hi all, apparently all of us have reached the halfway mark of our respective placements. Phew! Don't know about you guys/gals but the very tedious mid-assessment has been a reminder to me that there is always so much to read and learn, so much to experience and so much to ponder.

Questions abound and one that was asked which I recall quite clearly was : "Pneumonia is such a common diagnosis, so how do you make the decision of seeing or not seeing the patient?"

The picture of patients coughing madly, sneezing, feverish and drowning in their own thick greenish sputum came to my mind.

To play safe, I gave a very all encompassing answer: "Erm... Think I would see ALL of them first."

It was to be my doomed answer.

"As a healthcare professional in future, you should learn how to prioritize your patient list for proper time management and by knowing and understanding the conditions clearly, it will help you do so. Please read up. It's a good starting point."

How true.

Anyway, I decided to really read up on pneumonia and realized that its a horrendously big topic. And I thought my glasses couldn't get any thicker.

Here's what I found up so far and tried to condense some points together:

Signs and Symptoms:
Bacterial Pneumonia

• High fever
• Shaking chills
• Shortness of breath
• Chest pain
• Sweating
• Cough that produces thick green/yellow phelgm

Viral Pneumonia

• Flu-like symptoms
• Starts with dry/non-productive cough, fever, headache, muscle pain, fatigue
• Progresses to a cough that produces small quantities of phelgm(clear/white), SOB

Mycoplasma Pneumonia

• Very mild flu-like symptoms
• Dry, persistent cough
• Weakness

Fungal Pneumonia

• Uncommon
• Varies from no symptoms to chronic pneumonia

We typically need to see the first two groups and the most productive ones are the bacterial infected ones. But it does not rule out seeing the rest of them. They may have ventilation issues too.

Check the notes/PACS first to confirm diagnoses and investigations.

• Medical history
• Doctor's physical examination(especially auscultation eg coarse crackles)
• Chest X-rays(localize area)
• Blood tests: WCC, any bacteria, viruses or any organisms in blood(so we can classify and determine a brief picture of the patient)
• Sample of Sputum: micro-organisms etc.

Of course, the list is inexhaustible and not fool-proof. There are always special cases.

I have just started to read about the different names/families of the microbes cos its a mouthful and just too much. But I will persevere on.

Dear all, do help with the list and add on(if you have time and are interested). Or just anything about pneumonia. Guess it'll be a little something new to read everyday. Sounds crazy though. Till the next post, hang in there!