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Thu Jun 13, 2019, 04:06 PM

I've had three patients so far this week who came in to the clinic complaining of pneumonia.

Really? In this weather? Days: hot and dry; nights: warm and dry.

I look them over. Sure enough: common garden-variety cold symptoms. Not even a hint of pneumonia. I treated them symptomatically.

Do they say they have pneumonia because they think that sounds more dramatic? What gives?



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Reply I've had three patients so far this week who came in to the clinic complaining of pneumonia. (Original post)
Aristus Jun 2019 OP
MicaelS Jun 2019 #1
Aristus Jun 2019 #4
still_one Jun 2019 #2
Aristus Jun 2019 #6
RKP5637 Jun 2019 #3
LakeArenal Jun 2019 #5
hlthe2b Jun 2019 #7
Aristus Jun 2019 #10
hlthe2b Jun 2019 #12
Aristus Jun 2019 #14
hlthe2b Jun 2019 #15
ProudLib72 Jun 2019 #17
unblock Jun 2019 #8
cwydro Jun 2019 #9
Aristus Jun 2019 #11
llmart Jun 2019 #18
Bayard Jun 2019 #13
edbermac Jun 2019 #16
KT2000 Jun 2019 #19
Tipperary Jun 2019 #20
KY_EnviroGuy Jun 2019 #21

Response to Aristus (Original post)

Thu Jun 13, 2019, 04:09 PM

1. If they are older than 50...

That might be the answer.

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Response to MicaelS (Reply #1)

Thu Jun 13, 2019, 04:11 PM

4. Then they should know better.

The common cold is common because it's common. That may be overstating the case a bit. But you get the idea. It's much more common than pneumonia.

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Response to Aristus (Original post)

Thu Jun 13, 2019, 04:09 PM

2. an x-ray would confirm it

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Response to still_one (Reply #2)

Thu Jun 13, 2019, 04:13 PM

6. No need.

When all else fails, look at the patient. No fever, no chills, no night sweats, no respiratory distress, oxygen saturation within normal limits, lungs clear as a bell on auscultation, no dullness to chest percussion. Common cold.

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Response to Aristus (Original post)

Thu Jun 13, 2019, 04:11 PM

3. Maybe there is so much drama today they felt they had to keep up or that it is now the norm. n/t

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Response to Aristus (Original post)

Thu Jun 13, 2019, 04:11 PM

5. The Tee Vee gets people hyped about medicine.

“Ask your Dr for Astravenica”.
Got any left?

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Response to Aristus (Original post)

Thu Jun 13, 2019, 04:19 PM

7. Community acquired pneumonia is no longer considered a seasonal disease...

Certainly, Strep and Influenza cases remain higher in winter/fall, but Legionella, Mycoplasma and several other organisms are quite prevalent causes of CAP in spring/summer.

https://onlinelibrary.wiley.com/doi/full/10.1111/resp.12978
Seasonality of pathogens causing community‐acquired pneumonia
Catia Cilloniz, Santiago Ewig, Albert Gabarrus, Miquel Ferrer,Jorge Puig de la Bella Casa, Josep Mensa, Antoni Torres


I gather you are saying they are all negative for consistent symptoms on PE and/or radiographs? Perhaps they are accustomed to their "elders" referring to "walking pneumonia" -- a lay term I vividly recall for "mild pneumonia" or general spring/summer respiratory disease growing up.

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Response to hlthe2b (Reply #7)

Thu Jun 13, 2019, 05:01 PM

10. That's why I examine my patients very carefully.

One must always keep Occam's Razor in mind: the most common solution is usually the correct one.

Walking pneumonia is known clinically as 'atypical pneumonia', and comes with all of the usual hallmarks of community-acquired pneumonia; cough, respiratory distress of varying severity, dullness to percussion, and lung consolidation. the patient is simply able to walk around with the symptoms, instead of being bed-ridden. I get a case of it every now and then in clinic.

Legionella is an important one to look out for, since it most commonly incubates in air conditioning or water-recirculating systems. And there are more and more of those here in the Pacific Northwest as the climate warms up. All the same, I've never knowingly encountered a case of it in clinic.

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Response to Aristus (Reply #10)

Thu Jun 13, 2019, 05:05 PM

12. Walking pneumonia is merely a lay term for mild pneumonia. Nothing magical about the term.

but as I mentioned it is usually due to Mycoplasma--common in spring/summer and often self-limited sans treatment so that the prevalence and incidence is likely to be underestimated.

The key point is that CAP is NOT only a winter-fall disease--epidemiologically and statistically speaking, some of those complaining may well have mild pneumonia.

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Response to hlthe2b (Reply #12)

Thu Jun 13, 2019, 05:10 PM

14. Not the ones I examined.

Common cold, the lot of them.

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Response to Aristus (Reply #14)

Thu Jun 13, 2019, 05:12 PM

15. Good to hear...

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Response to hlthe2b (Reply #12)

Thu Jun 13, 2019, 09:14 PM

17. I've had walking pneumonia, and it's a misnomer

Should be "stumbling for the half hour you can keep yourself upright pneumonia." Had it during my semester abroad in Dublin. It lasted for about a month, maybe up to 6 weeks. I was barely functioning. Luckily, the Irish have good, strong OTC medicine...with codeine. Man is it horrible to have fever sweats and chills in the damp Irish climate during winter!

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Response to Aristus (Original post)

Thu Jun 13, 2019, 04:29 PM

8. I got the rocking pneumonia. I need a shot of rhythm and blues.

I caught the rolling arthritis sitting down by the rhythm revue.

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Response to Aristus (Original post)

Thu Jun 13, 2019, 04:54 PM

9. Jim Henson contracted pneumonia in May, and died from complications shortly thereafter.

Hardly winter.

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Response to cwydro (Reply #9)

Thu Jun 13, 2019, 05:02 PM

11. I'm not saying it doesn't happen.

Simply that in warmer weather, it's not necessarily the first diagnosis an infected patient should jump to.

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Response to Aristus (Reply #11)

Fri Jun 14, 2019, 06:30 AM

18. I had pneumonia two years ago in the spring.

I'm not one to run to the doctor for every twinge or cough. Two years ago I had a cough that wouldn't go away and after two weeks of feeling run down, no energy, and eventually coughing so hard I couldn't get dressed to go to work, I went to urgent care where they did X-rays and said I had pneumonia. They and my primary care doctor told me that if this ever happened again, I should make sure I got checked out/X-rayed for pneumonia. The next year I had another really bad cough, and general lack of energy/appetite for almost two weeks, so I went back to the same urgent care, they X-rayed me and said, no it wasn't pneumonia. This year in May, it happened again. I gave it a bit more than two weeks and it eventually went away, but boy, did that seem like a long time to be hacking. I'm 70 years old by the way and really healthy. However, I have a grandbaby that's in daycare and ever since she was born I've had these colds that appear after a day of babysitting. Guess my immune system isn't what it used to be.

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Response to Aristus (Original post)

Thu Jun 13, 2019, 05:10 PM

13. A few months ago...

I went to my pulmonologist, and told him I thought I had another pesky respiratory infection. He checked me out, and said, no--you have pneumonia.

Go figure.

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Response to Aristus (Original post)

Thu Jun 13, 2019, 07:35 PM

16. I had it and didn't know it.

Started coughing up blood and had a stay in the hospital for a week.

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Response to Aristus (Original post)

Sat Jun 15, 2019, 03:36 AM

19. I have heard some horrible

coughs from people when I go shopping, sometimes I think they must have pneumonia. It has been enough to keep out of stores!

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Response to Aristus (Original post)

Sat Jun 15, 2019, 04:01 AM

20. Maybe they are just scared because they do not feel well?

They are not well educated?

I surely hope you do not use any kind of snide or condescending tone towards them simply because they came to the clinic for help. That kind of attitude can discourage people from seeking help in the future.

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Response to Aristus (Original post)

Sat Jun 15, 2019, 05:18 AM

21. As Post #5 suggested, maybe there's a blitz of ads on TV...

that discussed some dangers of pneumonia, creating unwarranted fears even when having a cold.

In this day and age, it also wouldn't surprise me that some bullshit got spread on social media say, about some super bug version of pneumonia that scared a bunch of people.

I really does sound like false fears because normally, common people associate sign of pneumonia with something you physically feel such as weakness with congestion or difficulty breathing.

KY........

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