2019 IDSA Guidelines for Community Acquired Pneumonia in Adults: To HCAP, we just say fare thee well
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Jon-Emile S. Kenny MD [@heart_lung] with illustrations by Carla M. Canepa MD [@_carlemd_] “Better never means better for everyone... It always means worse, for some.” -Margaret Atwood Case A 73-year-old woman with a history of severe chronic bronchitis, ESRD receiving thrice-weekly hemodialysis and heart failure with a preserved ejection fraction is admitted from home with fevers, cough, vomiting and a right lower lobe consolidation on CXR. In 2016, she had a similar presentation, culminating in 4 days of mechanical ventilation in the ICU. At that time, she grew P. aeruginosa from a tracheal aspirate 3 days into her ICU stay. With her current presentation, she is well-appearing with a CURB-65 score of only 1 without unanticipated bloodwork abnormalities; all of her previous culture data – including MRSA nares – is negative. You wonder what her initial anti-microbial therapy should be?
2019 IDSA Guidelines for Community Acquired Pneumonia in Adults: To HCAP, we just say fare thee well
2019 IDSA Guidelines for Community Acquired…
2019 IDSA Guidelines for Community Acquired Pneumonia in Adults: To HCAP, we just say fare thee well
Jon-Emile S. Kenny MD [@heart_lung] with illustrations by Carla M. Canepa MD [@_carlemd_] “Better never means better for everyone... It always means worse, for some.” -Margaret Atwood Case A 73-year-old woman with a history of severe chronic bronchitis, ESRD receiving thrice-weekly hemodialysis and heart failure with a preserved ejection fraction is admitted from home with fevers, cough, vomiting and a right lower lobe consolidation on CXR. In 2016, she had a similar presentation, culminating in 4 days of mechanical ventilation in the ICU. At that time, she grew P. aeruginosa from a tracheal aspirate 3 days into her ICU stay. With her current presentation, she is well-appearing with a CURB-65 score of only 1 without unanticipated bloodwork abnormalities; all of her previous culture data – including MRSA nares – is negative. You wonder what her initial anti-microbial therapy should be?