Week 4 Case Study 1

Review the pulmonary infection scenarios and discuss whether the diagnosis is infectious rhinitis, influenza, acute bronchitis, acute bronchiolitis, or pneumonia. Discuss the most common pathogen and mode of transmission Discuss data that support your decision and treatment strategies.
Scenarios 1: Jack is a 21-year-old complaining of a sudden onset of myalgia with his body aching all over and headache for the past day. He feels tired and has the chills, and his temperature was 100°F. He has a mild nonproductive cough. He denies rhinorrhea, sinus pain, nausea, otalgia, or shortness of breath. He reports exposure to sick contacts in his dorm, stating, “Everyone seems to be coughing and catching a cold or the flu.”
• Medications: none.
• Allergies: penicillin.
• Past medical history: healthy.
• Social history: college student, lives in a dormitory. Nonsmoker and drinks alcohol once a week, about two or three beers.
• Physical examination: vital signs – temperature 100°F; pulse 98 beats per minute; respiratorations18 per minute; blood pressure 110/70 mmHg; pulse oximeter 98%.
• General: ill and tired appearance.
• Head, Eyes, Ears, Neck, Throat: unremarkable.
• Neck: no lymphadenopathy; negative Kernig sign, negative Brudzinski sign.
• Cardiovascular lungs, abdomen: unremarkable.

Answer the following questions or provide responses based on this scenario.
1. What is the most likely diagnosis and pathogen causing this disorder?
2. Discuss the mode of transmission and discuss the data that supports your decision.
3. What diagnostic test, if any, should be done?
4. Develop a treatment plan for this patient.
Scenarios 2: Mr. Menendez is a 65-year-old man presenting with 2–3 days of coughing up thick yellow sputum, shortness of , and fever (he did not check the actual temperature), and chills. He states his chest hurts when he breathes. He denies headache, rhinorrhea, sinus pain, and nausea. He reports no exposure to sick individuals.
• Medications: lisinopril 10 mg a day by mouth.
• Allergies: no known drug allergy.
• Social history: smokes 1 pack of cigarettes per day (has done so for 30 years); denies alcohol use; works as a landscaper.
• Physical examination: vital signs – temperature 101°F; pulse 98 beats per minute; respirations 22 per minute; blood pressure 140/86 mmHg; pulse oximeter 93%.
• General: ill and tired appearance, coughing during visit with thick yellow sputum noted.
• HEENT: unremarkable.
• Neck: small anterior and posterior cervical nodes.
• CV: unremarkable.
• Lungs: right basilar crackles with dullness to percussion in right lower lobe.
• Abdomen: unremarkable.

Answer the following questions or provide responses based on this scenario.
1. What is the most likely diagnosis and pathogen causing this disorder?
2. Discuss the mode of transmission. Discuss the data that support your decision.
3. What diagnostic test, if any, should be done?
4. Develop a treatment plan for this patient.