A 66-year-old man presents with shoness of breath, myalgia, headache along with multiple episodes of fever with rigors. He went to the local doctor who treated him for the flu. However, his symptoms worsened, and by the day of presentation he was complaining of a dry cough and marked shoness of breath and diarrhoea. Patient is a non-smoker. Auscultation of chest reveals bilateral crackles and bronchial breathing in both lower zones posteriorly. Lab findings, Elevated CRP level Hypocalcemia Acidosis and marked hypoxia Gram staining of sputum revealed small, pleomorphic, faint, gram negative bacilli. Chest X-ray What is the drug of choice of the above organism: -
This is a case of Legionella pneumophila pneumonia. The diffuse infiltrates on chest X-ray suggest atypical pneumonia, whereas a lobar pattern tends to occur with streptococcal pneumonia. The 4-day prodromal illness is typical of Legionella pneumonia. Pneumococcal pneumonia which tends to present abruptly with fever and shoness of breath. Legionella infection presents with myalgia, headache and fever. Patients may develop diarrhoea and abdominal pain. As the illness progresses the patient develops a dry cough, chest pain, shoness of breath and acute confusion. 1st line drugs are: - 1. Azithromycin 2. Ciprofloxacin
Azithromycin
Ampicillin
Vancomycin
Gentamycin
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