Quick diagnostic and management community acquired pneumonia at Sumbawa hospital: a case report

Muhammad Ahmad Syammakh, Elim Jusri, Gede Agung Setya, Made Aryadi Sukartika


Pneumonia is most common cause of respiratory distress an infection of the pulmonary parenchyma. Despite being the cause of significant morbidity and mortality, it is often misdiagnosed, mistreated, and underestimated. Pneumonia historically was Typically classified as community-acquired (CAP), hospital-acquired (HAP), or ventilator-associated (VAP). A 68-year-old male was sent to the emergency department from clinic with an oxygen saturation of 86%. She has fevers with cough and generalized weakness for one week. She had been evaluated by her primary care provider on day two of illness and was started empirically on cefixime without improvement of her symptoms. The patient arrived febrile, tachycardic, tachypneic, and hypoxic on room air with right-sided crackles on exam. Lung Ultrasound of the right lower lobe demonstrates lung hepatization, a classic finding for pneumonia. In addition, a shred sign is present with both air bronchograms and focal B lines-all suggestive of poorly aerated, consolidated lung. Authors critically evaluate the evidence for the use lung ultrasound for rapid diagnostic. It is important to understand this disease, rapid diagnostic with ultrasound and when treated promptly and effectively, these patients will rapidly recovery. Good oxygenation, intravenous Antibiotic, intravenous fluids and symptomatic treatment which should be started within minutes of the patients’ arrival to emergency department.


Antibiotic, Lung ultrasound, Oxygenation, Pneumonia, Rapid diagnostic

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Angus DC, Marrie TJ, Obrosky DS, Clermont G, Dremsizov TT, Coley C, et al. Severe community-acquired pneumonia: use of intensive care services and evaluation of American and British Thoracic Society Diagnostic criteria. Am J Resp Critical Care Med. 2002 Sep;166(5):717-23.

Kellum JA, Kong L, Fink MP, Weissfeld LA, Yealy DM, Pinsky MR, et al. Understanding the inflammatory cytokine response in pneumonia and sepsis: results of the Genetic and Inflammatory Markers of Sepsis (GenIMS) Study. Arch Internal Med. 2007 Aug 13;167(15):1655-63.

Mandell LA, Anzueto A, et all. “Management of Community Acquired Of pneumonia in adults.” Infectious Disease Society of American Thoracic Society. Clin Infect Dis, 2007. S27-S72.

Mandell LA. In:Harrison Textbook of Principle Internal Medicine. 20 Th. Mc Graw Hill;2018;5: 908-912.

Prina E, Ranzani OT, Torres A. Community acquired pneumonia. Lancet. 2015 Sep 12;386(9998):1097-108.

Restrepo MI, Mortensen EM, Rello J, Brody J, Anzueto A. Late admission to the ICU in patients with community-acquired pneumonia is associated with higher mortality. Chest. 2010 Mar 1;137(3):552-7.

Sligl WI1, Marrie TJ. Severe community-acquired pneumonia. Crit Care Clin. 2013 Jul;29(3):563-601.

Woodhead M, Blasi F, Ewig S, Garau J, Huchon G, Ieven M, et al. Guidelines for the management of adult lower respiratory tract infections-full version. Clin Microbiol Infection. 2011 Nov 1;17:E1-59.

Litchenstein. Lung Ultrasound In:The Critically Ill. Springer. 2016;6:112-20.