Pneumonia symptoms based on patient age and health status

Pneumonia is an infection of the lungs. However, symptoms of pneumonia may not be confined to your lungs. There are several online symptom checkers on major medical information websites that list several symptoms of pneumonia. However, symptoms of pneumonia depend more on the severity of pneumonia and the unique characteristics of the patient than just having a diagnosis of “pneumonia”. Here are a summary of how few different patients presented with pneumonia. Of note, in “Symptoms and Diagnosis” we do not list symptoms, we tell a story of the symptoms. List of symptoms do not help in making the right diagnosis without the proper context and the story of how the illness progressed.

Pneumonia symptoms in a 24 year old otherwise healthy female student:

Miss T is a 24 year old female college student who has just returned home to visit her parents for the summer. She had felt like she was “getting down with something” for the last 2-3 days. She initially thought she might have the flu. However, she was coughing more and more. She never had a “cold” this bad. She also started having high fevers with shaking chills. Her appetite went down. She felt very weak.

When her parents saw her, they were extremely worried. She looked very sick. She confessed that she had not had much food or drink in the last 2 days. Her mother immediately prepared some chicken soup for her to help her get over the cold. She tried a few spoonful of the soup but could not finish it. As her mother forced her to take a few more, she became very nauseated. She ran to the bathroom and vomited all the soup she had.

Her mother got worried and drove her to the nearest emergency department. There, she had a chest x-ray. It showed a haziness on the right lower side of her chest. Her blood tests were relatively normal except for a slightly low potassium. She was given a prescription for antibiotics and anti-nausea medications and was discharged home. She felt better in about 3 days and was back to normal within a week.

Pneumonia symptoms in a 72 year old female with a recent stroke:

Mrs Y had a stroke 4 weeks ago. She had complete paralysis of her left side. She was admitted to the hospital that time and had received clot busting medication for the stroke within an hour of her symptoms. She did have some partial recovery. At the end of the hospital stay, she had been able to partially move her left arm. She was also able to move her left leg a little bit but did not have enough strength to stand up. She was recovering at home after a week in rehab. She was still in a wheelchair but was able to push herself around the house. Her daughter had moved in with her to help. She still had some trouble swallowing food properly and they had recommended a specific diet of certain consistency to avoid choking.

She was feeling better and went to physical therapy at least 3 times a week. That particular day, it seemed like she was not doing well at the therapy session. She felt like she had no energy. She could not do things she had remastered in the last week. She was still able to push her wheelchair but it was very slow. She did not feel like eating. She also noticed she was breathing a little faster. She did have some cough but did not cough up anything. She also had a new headache. She never had headache with the actual stroke. Her therapist was worried and called her daughter.

They decided it would be best to take her back to the emergency department for a check-up. In the ER, they did a CT scan of her head as soon as they heard the story. The CT was unchanged since her stroke. Subsequently, they ordered some blood work and a chest x-ray. The blood work showed that her White blood cell count was 18K, normal being 4.5K to 10K. Her chest x-ray showed diffuse haziness in the lower parts of both her lungs. She was admitted to the hospital with a diagnosis of pneumonia and was started on IV fluids and IV antibiotics. Her oxygen level was low. She was placed on supplemental oxygen to help her breathe better. She remained in the hospital for 3 more days.

Pneumonia symptoms in a 82 year old female in a nursing home:

Mrs Z had history of multiple medical problems. She had underlying heart disease. Her kidneys were only functioning at about half the capacity. She also had a history of blood clot in her lungs and was taking blood thinners. The clot had originated in her left leg and apparently it got lodged in her lungs. She was overweight but not obese. She still have some shortness of breath with walking. She had that for a long time. It worsened at times and improved at times. However, she was mentally very sharp and focused. She liked her books and spend most of her time reading. She also enjoyed watching the news on television and was up-to-date on all recent events.

One morning, she appeared different. Her nurse was concerned. She seemed very withdrawn. That was not normal for her, she was a very chatty person. She asked what happened. “I am very tired today,” Mrs Z replied. The nurse reassured her and asked her what she would like for breakfast. Mrs Z said,“I don’t fell like eating today. I don’t even want to clean the garage. I thought I would do it today but maybe tomorrow.” The nurse was worried,”What garage?” “Well, my garage, I was thinking about sweeping the dust out. You know I live by myself, don’t have much help around the house.”

Now the nurse was really worried. It did not make sense. She called 911 and had her taken to the nearest emergency department for evaluation. She was diagnosed with pneumonia. She also had worsening of her kidney function and signs of sepsis. Her body was overwhelmed from the infection. She required five days in the hospital for treatment.

Pneumonia in a 68 year old male with advanced COPD:

Mr S is a 68 year old male who had smoked more than a pack a day for 40 years. He was diagnosed with COPD 4 years ago but had not been able to stop smoking. COPD or Chronic Obstructive Pulmonary Disease is a lung disease that happens mostly in smokers. It caused his lungs to become stiff and his airways were inflamed and constricted. He had ongoing cough and trouble breathing. He was placed on 2 liters of oxygen all day to help his breathing.

That particular day, he felt like his shortness of breath was worse than usual. He was running out of breath just getting out of his bed. He increased the flow of his oxygen but still did not feel better. He also had a pain in the right side of his chest every time he coughed or took a deep breath. His wife looked at him and was very worried. His color did not not look right. She felt like he was about to collapse. She called 911 right away.

Paramedics came in and checked his vitals. His oxygen was very low at 75% even with the oxygen. He looked very short of breath and was breathing very heavy. They increased the flow of oxygen with a face-mask and it went up to 89%. They transported him to ER right away.

In the ER, his oxygen continued to drop despite the face mask. The ER doctor decided to put a tube down his throat to help him breathe. He was hooked up to a ventilator. They finally got a chest x-ray and some blood work. He had pneumonia with sepsis. His blood pressure started to go down and became very low. He was resuscitated with IV fluids and IV medications to push his blood pressure up. He was started on 3 different IV antibiotics and was admitted to the intensive care unit (ICU).

Here, you read about 4 different patients with the same diagnosis of pneumonia but saw how their symptoms were completely different. They all had different levels of treatment and different prognosis.

This book “Symptoms and Diagnosis” has very detailed stories of patients affected with diseases of all organ systems. They teach you about diseases and their symptoms in a very easy manner. Each story links the symptoms to what happened inside your body. You will learn basic medical knowledge to make sense of what your body is trying to tell you when you get sick. You just have to read these stories and the analysis. It will truly empower you with knowledge that might one day help save a life.