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Pulmonary Medicine Flashcard

Patient presents with:

• Sore throat and malaise for 7 days, negative for strep, and then developing hoarseness with low-grade fevers and cough. She reports several of her friends from her gym class have had recent flu-like symptoms. 
  
  
• Normal WBC
  
  
• CXR: patchy infiltrate

What's the diagnosis?

Before reading the answer

Dredge up everything you know about pulmonology, and try to form a diagnosis.

Answer

Chlamydia pneumoniae community-acquired pneumonia (CAP)

Explanation

The history in this case gives you what you need to know: Sore throat, hoarseness, and pneumonia, as a collective group of symptoms, are associated with Chlamydia (formerly Chlamydophila) pneumoniae infection. Outbreaks at nursing homes, college dorms, and military barracks have been reported. 

Dx: Clinical; organism is very difficult to culture and, if needed, PCR tests are available for use on respiratory specimens. Empiric treatment is perfectly acceptable and standard. 

Targeted Tx: Azithromycin or other macrolide x 5 days is 1st line. Alternatively, fluoroquinolone x 7 days.