I was simply saying since we are gonna do Q&A we may as well make it beneficial to a broader populace here by discusing combat medicine as opposed to sick call/medical subjects. I believe our time will be better spent talking about scenarios centered around things guys on here may see and be able to treat such as arterial bleeding, amputations, dyspnea after blunt/penetrating trauma to chest/abdomen, and the list goes on, as opposed to talking about the difference(s) in pneumococcal, staphlococcal, myoplasmic, and streptococcal Pneumoniae just to name a few, or the difference(s) between African and American Trypanosomiasis.
Besides, of the 128 case studies every good Delta knows the two deciding factors in any med illness is a fever and a petechial rash.
And with that,
Basics of Pneumococcal Pneumonia
Pneumococcal pneumonia is caused by Streptococcus pneumoniae (pneumococcus). Generally appears after an URI-V damages airway defenses which allows bacteria (staph in this case) to infect the area.
Pneumococcal pneumonia, although usually treatable, can be fatal, especially in the very young, the very old, and those people who have other severe illnesses (caveat for most disease prognosis). It can lead to pneumococcal septicemia or pneumococcal meningitis if left untreated.
C/C: Shaking and chills, with associated fever, productive cough-sputum brown, dyspnea, and chest pain w/ respiration, on the affected side. N&V and general malaise are also common.
HOPI: Preceeded by Cold or Flu generally.
Symptoms: sudden shaking chills, N&V, rapid onset fever, pluritic type C/P, SOB, productive cough w/ blood tinged sputum, malaise and myalsia.
Signs: Appears in distress, BBS decreased on affected side/lobe(s) or may have rales, hyporesonant over same, tachycardic, tachypnic, HTN. high fever (100.4-105F), SAO2 </=96% RA, cyanosis.
Labs: CXR: infiltrate/consolidation PP usually presents w/ single lobe involvement as opposed to multiple lobes.
WBC/Diff: Leukocytosis >13,000 with L shift (Bands/Segs)
Gram stain: Gram +, diplococci chains and pairs
Diff Dx1: Bronchitis
Diff Dx2: TB
Diff Dx3: Viral Pneumonia
Diff Dx4: PE
Tx: Admit to clinic if indig soldier/evac US soldier, Pen V 500mg QID x 7 days or Clindamycin 300mg QID x 7days (if treating empirically Erythromycin is DOC), supp. care, O2(if SAO2<94%). Repeat CXR/WBC/Gram stain x 7 days or PRN until resolved.
Prognosis Good (>90%) with PT compliance to treatment regime.
Well that covers the "off the top of my head" info on PP.
Crip
(long day of dental medicine...)