80 years female presented with cough fever(99-100) mild breathlessness since 4-5 days Lab wbc 43000 sputum for afb negative esr 44 give your expert opinion



Difficult to give an opinion with Incomplete information available with the case.. Any past history of Asthma.. What is the oximetry status.. ABG report? Any echocardiogram done or not............ Looks like ARDS /acute lung injury.. Pulmonary edema is also a possibility...

not history of asthma maintaining spo2 above 90. without o2 ecg normal echo is not done

If histry is longer ,IPF shld be cnsderd as primary diagnosis with secondary infection bilateratl pneumonia of such kind wld have caused much hypoxia.Also ALI due to some secndry systemic infection is a psbly.It may ppt into ARDS ....perform PS for MP and wida test too and get a HRCT done asap...

Clinically a case of sepsis with ARDS or impending ARDS .. You will to hit early and hit hard.. Or may lose the patient

The high WBC Count is suggestive of bacterial infection and should be treated with injectable therapy containing clarithromycin and Augmentin along with supporting medication for dyspnoea.

have started inj piptaz 4.5 gm tds wbc count decreasd upto 30000

Its good that the patient is not having hypoxia.. X-ray shows wide spread involvement..

Mild pleural effusion right with bilateral pulmonary koch's, advised AKT.

pneumonia need culture Sensitivity

seems like there is some underlying lung pathology.. may b ILD or bronchiectasis which got super added bacterial infection. get sputum cultures.. Augmentin and macrolide should do.. pending cultures

high wbc count suggestive of bacterial infection,, may be in pneumonia impending ARDS WITH type 1 respiratory failure treat with piptaz and linezolid infusion,, better to done an ABG,, oxygenation, nebulization,, higher antibiotic, and supportive care , close monitoring , slowgun hit early and hit hard is very much usefull

should be treated with cephalosporins IV .and along with montelokost and levocetrizine combinations od dosage so that sputum will be clear .and along with augmentin half tablet daily for 5 days

Bil Ll pneumonitis, secondary to LRTI., bronchiectasis, ILD to be ruled out.as counts r coming down continue antibiotics, evaluate with HRCt chest

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