Health & Medical Question

Case Scenario:

Discussions will be unfolding in nature with additional components of the case presented in a stepwise manner on different days to promote continual engagement throughout the week.

Infectious Disease Unfolding Case Discussion

A 48-year-old male presents to the office after being discharged from the hospital 14 days ago for community-acquired pneumonia. PMH significant for COPD and cigarette smoking. He was recovering well from CAP with minimal SOB and cough. Denies wheezing.  He received both influenza and pneumococcal vaccine in the hospital. He complains of new onset diarrhea today started three days ago and feeling ill.

What additional historical (subjective) information is needed?

Expert Solution Preview

Introduction: In this case scenario, we are presented with a 48-year-old male who was recently discharged from the hospital after being diagnosed with community-acquired pneumonia (CAP). The patient presents with new onset diarrhea and feelings of illness. As healthcare providers, it is important to gather additional historical information to aid in the diagnosis and treatment of the patient.

Answer: To effectively diagnose and treat the patient, additional historical (subjective) information is needed. The healthcare provider should ask the patient about the frequency, consistency, and characteristics of the patient’s diarrhea. Other questions that should be asked include the patient’s recent dietary habits, recent travel history, and any recent use of antibiotics that predisposes them to an infectious cause of diarrhea. The provider should also inquire about any known exposures to individuals with infectious diarrhea or outbreaks of gastrointestinal illness in the community, as this could point towards a possible source of the patient’s symptoms. Additionally, the provider should ask about any other symptoms the patient may be experiencing, including fever, abdominal pain, nausea, and vomiting, which could point towards the underlying cause of the diarrhea.

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