4.4 of 13 Ratings
A 78-year-old female is brought to her primary care doctor by her daughter after developing worsening cough, shortness of breath, and shaking chills over the past 3 days. The patient's cough has not produced any sputum. She also complains of alternating feelings of being 'hot then cold.' Whenever she coughs or breathes deeply, she experiences a severe sharp pain in her chest. The patient lives at home with her daughter and is otherwise healthy. Her past medical history is significant for hypertension treated with losartan and hyperlipidemia managed with atorvastatin. The patient does not have a history of tobacco use. Vital signs recorded in the office are as follows: T 38.7, HR 101, BP 135/78, RR 16, and SpO2 94%. Physical exam is significant for crackles in the right upper lung field. The patient is transferred to the local emergency department for further evaluation and management and a chest radiograph is obtained (Figure A). Which of the following is the most likely causative organism in this patient's presentation?
Group A streptococcus
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A 56-year-old previously healthy woman with no other past medical history is post-operative day one from an open reduction and internal fixation of a fractured right radius and ulna after a motor vehicle accident. What is one of the primary ways of preventing postoperative pneumonia in this patient?
In-hospital intravenous antibiotics
Outpatient oral antibiotics
Shallow breathing exercises