Patient will present as → a 45-year-old male with a one week history of hacking non-productive cough, low grade fever, malaise and myalgias. The chest x-ray reveals bilateral interstitial infiltrates and a cold agglutinin titer that is negative. Examination reveals scattered rhonchi and rales upon auscultation of the chest.
Adults → Flu is the most common viral cause
Kids → RSV - 1st episode of wheezing
Adenovirus tends to cause symptoms fast, will present with GI symptoms and lasts about 1 week. May differentiate from bacterial mycoplasma pneumonia as mycoplasma is slow and insidious.
Chest X-ray will show bilateral interstitial infiltrates
- Rapid antigen testing for influenza
- RSV nasal swab
- cold agglutinin titer that is negative
Influenza can be treated with oseltamivir (Tamiflu)
- Zanamivir and Oseltamivir (Tamiflu) both treat influenza A and B must be given within 48 hours
- Amantadine and Rimantadine treat only influenza A
Treatment is usually symptomatic, may use beta 2 agonists, fluids, rest
CXR showing typical findings of bilateral interstitial infiltrates
Question 1 |
acute bronchitis Hint: While the patient's clinical symptoms of dry cough and rhonchi support this diagnosis, the chest x-ray would be normal or only show a mild increase in bronchovascular markings, not infiltrates. | |
viral pneumonia | |
mycoplasma pneumonia Hint: While the gradual onset of symptoms suggest mycoplasma, the negative cold agglutinin titer makes this less likely. | |
pneumococcal pneumonia Hint: In older children the signs and symptoms of pneumococcal pneumonia are similar to an adult and consist of an abrupt onset of cough, fever and chills. The chest x-ray would reveal a lobar consolidation, not interstitial, picture. |
