Case studies on atypical pneumonia

Case studies on atypical pneumonia

Open Ended

A 63-year-old man admitted to the hospital with the complaints of shortness of breath, chest pain, chills and fever of several days.

Upon discussion he revealed that he smoked one packets of cigrette everyday for more then 40 years; he had history of bronchitis. Physical examination revealed that this elderly man in severe respiratory distress with a temperature of 39 degree centigrade, pulse of 120 beats/minute, respiratory rate of 36 breaths/minute, and blood pressure of 145/95 mmHg. Chest radiograph revealed an infiltrate in the middle and lower lobes of the right lung. The white blood cell count was 14,000 cells/mm3 (80% polymorphonuclear neutrophils). Gram stain of sputum showed neutrophils but no bacterial cells but bronchial biopsy specimen of patient revealed gram negative rods. Diagnosis of atypical pneumonia is made

Which of the following is the most probable causative organism causing atypical pneumonia in this patient?

State two confirmatory test of this causative agent causing atypical pneumonia in this patient?

Mention the specific culture medium to culture the causative agent of atypical pneumonia in this patient?

Multiple Choice

A 63-year-old man admitted to the hospital with the complaints of shortness of breath, chest pain, chills and fever of several days.

Upon discussion he revealed that he smoked one packets of cigrette everyday for more then 40 years; he had history of bronchitis. Physical examination revealed that this elderly man in severe respiratory distress with a temperature of 39 degree centigrade, pulse of 120 beats/minute, respiratory rate of 36 breaths/minute, and blood pressure of 145/95 mmHg. Chest radiograph revealed an infiltrate in the middle and lower lobes of the right lung. Diagnosis of atypical pneumonia is made on the basis of microbiological investigations. The causative agent identified as Legionella pneumophila.

Which of the following is the best culture medium to culture this causative agent causing atypical pneumonia in this patient?

• Nutrient agar

• Lowenstein-Jenson medium

• Potassium tellurite agar

• Buffered charcoal yeast extract agar

Open Ended

A 21-year-old female admitted to emergency department of Shah Alam hospital with headache, nonproductive cough, low grade fever and shortness of breath. Her pulse rate is 95 beats/minute, and her respiratory rate is 28 breaths/minute. During physical examination, her pharynx is found erythematous; scattered rhonchi and rales but no consolidation is noted (On auscultation). Results of chest radiograph shown patchy infiltrates. A Gram stain of sputum revealed many white blood cells but no organisms. Fried egg specifically mulberry shaped colonies appeared on a growth medium supplemented with exogenous sterols supplied by animal serum. Diagnosis of atypical pneumonia is made.

Which of the following is most likely causative agent causing atypical pneumonia in this female?

State the pathogensis of causative agent causing atypical pneumonia in this female?

Mention the reason why this causative agent NOT detected by Gram staining?

State ONE (1) specific virulence factor used by this causative agent for attachment to respiratory epithelium.

Multiple Choice

Which of the following is the best confirmatory diagnostic test for atypical pneumonia caused by Chlamydophila pneumoniae?

• Culture

• Complement fixation test

• Microimmunofluorescence test

• Nucleic acid amplification test