Community-acquired pneumonia (CAP) has a significant influence on elderly individuals, who are affected more often and with more severe consequences compared with younger populations.
A clinical case of a 66-year-old man with complaints specific for CAP is discussed. The clinical diagnosis of CAP in the lower lobe of the right lung, respiratory failure (RF) II was made on the basis of the chest X-ray data (focal infiltration of the lung tissue), patient’s complaints of fever, cough with mucous sputum, history data (acute onset of the disease, association with overcooling; development of disease in out-hospital setting); inspection data (focus of weakening of vesicular breathing, the presence of moist fine bubbling rales during auscultation in the lower part of the right lung), blood test results (stab shift, elevated ESR). Level of RF was established on the basis of RR (24/per min).
Patient management includes an antibiotic combination of ampicillin-sulbactam 1.5 g IV 3 times per day plus azithromycin 500 mg orally daily for 10 days. We recommend CBC and X-ray control (at 7 to 12 weeks) after treatment.
The example of this clinical case highlights the features of pneumonia, diagnostic approach and antibacterial therapy in elderly patients. The significance of prevention namely lifestyle modification and vaccination is emphasized.