ABSTRACT
This chapter presents a case study of a 70-year-old woman with a 5-day history of worsening cough productive of yellow-green sputum and associated shortness of breath who is transferred to the Emergency Department by her General Practitioner. She has a history of type 2 diabetes, controlled on metformin, and hypertension, for which she takes amlodipine. The patient presents with respiratory symptoms with localising signs on examination and neutrophilic leucocytosis on laboratory evaluation. The likely diagnoses in this case would include bacterial pneumonia, viral upper or lower respiratory tract infection with or without superadded bacterial infection and pulmonary embolism. In terms of treatment, it would be appropriate to fluid-resuscitate this patient given mild hypotension and also to begin empiric antibiotics for community-acquired pneumonia (CAP). The choice of antibiotics should be based on local guidelines and susceptibilities, but typically includes a beta-lactam to cover Streptococcus and a macrolide for atypical coverage.
