Physician's Assistant

Rapidreview Sun 23 November 2025 21:49

Last Modified: 134 days ago

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Thank you for informing me about this patient, Dr Prasad.

DIAGNOSIS: Left lower zone community acquired pneumonia with raised CRP and increasing oxygen requirement

CLINICAL PRESENTATION:
CRP 266 mg/L. Patient has developed increasing oxygen requirement from 4L nasal specs to requiring Hudson mask (likely Venturi mask).

CURRENT TREATMENT:
IV co-trimoxazole and oral clarithromycin as per guidelines. Early in antibiotic course, no indication to change at present.

EXAMINATION:
Alert, GCS 15. Sweaty and diaphoretic. Heart sounds normal. Chest: transmitted upper airway sounds throughout with left lower zone coarse crepitations. Abdomen soft. No peripheral oedema.

PAST MEDICAL HISTORY:
Eosinophilic oesophagitis, previously on Jorveza (dispersible budesonide), however not taken in last 4 weeks. Adrenal insufficiency not considered a contributing factor given recent cessation and poor oral absorption of budesonide.

INVESTIGATIONS:
ECG: Sinus rhythm without evidence of ischaemia, rate 93 bpm

PLAN:
1. Move to resuscitation area
2. Nursing staff requesting Critical Outreach Team review
3. Titrate oxygen aiming for saturations 95%
4. Continue current antibiotics
5. Venous blood gas and repeat blood tests
6. Atypical pneumonia screen and HIV test
7. Sputum MC&S
8. New cannula

SUMMARY:
Patient with left lower zone pneumonia, increasing oxygen requirement in context of early antibiotic treatment.

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Rapidreview Sun 23 November 2025 21:49

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