Question

A 50 year old man with a history of chronic obstructive pulmonary disease (COPD) came to the emergency room because of a fever of 103ºF, chills, nausea, vomiting, and hypotension. The patient also produced excessive yellowish sputum, which he says has increased in quantity over the past 3 days. A chest x-ray showed extensive infiltrates in the left lower lung. Multiple blood cultures and culture of the sputum yielded S. pneumoniae.

What is the presumptive diagnosis for this patient?

What other organisms can cause this type of disease?

What role could COPD play in this disease? What other populations of patients are susceptible to these infections?

How would you treat this patient?

What are the major virulence factors of S. pneumoniae?

This organism belongs to the genus Streptococcus. What organism is also known as Group A Streptococcus? What virulence factors does this organism possess?

Answer 1

A) The presumptive diagnosis is pneumonia. The microorganism found in the sputum samples and the symptoms are positive of pneumonia.

B) Legionella pneumophila is the bacterial type that causes the pneumonia known as Legionnaires' disease. Other bacteria types that can cause pneumonia include Legionella pneumophila, Mycoplasma pneumoniae, Chlamydophila pneumonia and Haemophilus influenzae.The most common cause of viral pneumonia in adults is the influenza virus.

C) People with COPD are more likely to develop pneumonia. It can cause an increased risk of respiratory failure. This is when your body is either not getting enough oxygen or isn’t successfully removing carbon dioxide.

D) People over the age 65 or under 2, having certain chronic medical conditions (including underlying lung disease, cigarette smoking, alcoholism, and neurological problems), or sustaining injuries that interfere with swallowing or coughing are more susceptible to these infections.

E) People with COPD and pneumonia are normally admitted to the hospital for treatment. Antibiotics are likely to be administered intravenously.Doctor may prescribe glucocorticoids. They can reduce the inflammation in your lungs and help to breathe. These can be given through an inhaler, a pill, or an injection. Doctor will also prescribe medications in nebulizers or inhalers to further help breathing and manage the symptoms of COPD.Oxygen supplementation and even ventilators may be used to increase the amount of oxygen.

F) The virulence factors include the polysaccharide capsule, surface proteins and enzymes, and the toxin pneumolysin (PLY)