Infectious Disease
Case 8: A Man in Hospital with a Temperature
CASE
A 79‐year‐old man is known to have advanced Parkinson's disease. He was initially admitted with reduced mobility. His anti‐Parkinson medication had been altered and his mobility was improving with physiotherapy input. He had no other past medical history and was a non‐smoker. On the fourth day of admission he started to spike a temperature and became unwell. He was short of breath, sweaty and complained of right‐sided pleuritic chest pain.
On examination he was febrile, tachypneoic and tachycardic and had an oxygen saturation of 93% on air. He had bronchial breathing on the right lower zone of his chest, and there was no wheeze. Heart sounds were normal and his abdominal system was unremarkable.
The following arterial blood gas (on air) results were obtained:
pH 7.36 PCO2 6.55 kPa PO2 8.65 kPa HCO3 28 mmol/L Base excess 4 mmol/L
Chest X‐ray: right lower lobe consolidation, no evidence of hyperinflation
ECG: sinus tachycardia, no evidence of ischaemia
QUESTION 1
Your score this session: 0 of 0
What type of pneumonia is this patient likely to have developed?