My primary diagnosis at this point
My primary diagnosis leads to a condition known as Community-Acquired Pneumonia (CAP). CAP is one of the respiratory conditions that are closely related to Hospital Acquired Pneumonia (HAP). While HAP affects individuals in healthcare facilities, CAP is common amongst individuals outside medical facilities. Some of the factors that substantiate my diagnosis espouse the symptoms associated with CAP.
Prina, Ranzani, and Torres (2015) allude that tachypnea, crackles, and high fever are signed, which indicate that the patient is suffering from CAP. In this regard, the symptoms presented by Leroy on his second visit to the clinic are similar to those associated with CAP. The symptoms advanced by Leroy are linked to respiratory issues, a phenomenon that guides medical practitioners to the conclusion that he is suffering from CAP. As such, the conclusion that Leroy suffers from CAP emanates from the similarity of his experiences and the symptoms of CAP.
The tests that I will perform
To ascertain fully that the patient suffers from CAP, I will need to undertake several tests. Some of the tests comprise CBC that represents a complete blood count, chest X-ray, and sputum. By testing the blood count, I will be in a position of analyzing and assessing whether Leroy’s blood has additional white blood cells. It is fundamental to explain that the presence of additional or extra blood cells is one of the predisposing factors, which confirm that the patient has CAP. Consequently, a chest X-ray helps reveal whether the lungs have fluids that lead to CAP (Feldman & Anderson, 2015). To get near precise results, I will use Computed Tomography (CT) X-ray because the common x rays may not give clear results. Furthermore, I will test Leroy’s sputum and the amount of oxygen in his blood.
Sputum tests are very important in examining the presence of bacteria or other causatives that may have initiated the eventuality of the disease. Besides, sputum tests help in establishing the presence of fluids in the respiratory system of the patient. For a clear examination of the bacteria or fungi that may have triggered the infection, I will undertake blood tests through the process referred to as blood culture.
Another important test that I will engage in is auscultation. Wunderink and Waterer (2014) explain that auscultation tests help medical practitioners listen keenly to the internal process of the body such as heartbeat rate and breathing using a stethoscope. Through the test, I will be in a better place to reaffirm the presence of pulmonary crackles and tachypnea that indicate the presence of the CAP.
Pharmacological treatment and its mechanism of action
Since Leroy appears fit and UT infections have diminished, I will provide medication that he will take at home. It is important to state that CAP is a condition that is treated using antibiotics. Some of the antibiotics that are useful in treating CAP include Doxycycline, Macrolide, and Quinolone. Therefore, with knowledge of Leroy’s health and age, I will use an antibiotic that best suits his condition. I will choose azithromycin, a macrolide, which addresses CAP by ensuring that mRNA translation does not materialize.
Musher and Thorner (2014) highlight that azithromycin is an antibiotic that interferes with the growth of bacteria because it hampers the synthesis of proteins that are vital in bacterial development. The dosage that I will prescribe espouses an oral intake of the antibiotic for five days. The patient will commence his medication by taking a single dose of 500mg and then proceed with a regular intake of 250mg per day for four days. Besides advising Leroy to continue taking water about eight glasses per day, I will also have him visit the clinic after 3 days so that I can check his progress.
References
Feldman, C., & Anderson, R. (2015). Community-acquired pneumonia: Pathogenesis of acute cardiac events and potential adjunctive therapies. CHEST journal, 148(2), 523-532.
Musher, D., & Thorner, A. (2014). Community-acquired pneumonia. New England journal of medicine, 371(17), 1619-1628.
Prina, E., Ranzani, O., & Torres, A. (2015). Community-acquired pneumonia. The lancet, 386(9998), 1097-1108.
Wunderink, R., & Waterer, G. (2014). Community-acquired pneumonia. New England journal of medicine, 370(6), 543-551.