Sample of patients in the unit today

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1st room: 3 patients


• Middle-aged lady with asthma now with pneumonia
• Elderly lady with pulmonary fibrosis now with worsening cough; Doing labs and tests to r/o PE; Chest CT (-) though spiral CT not available
• Middle-aged man with COPD now with pneumonia left AMA without discharge; Bed now available for patient transferring from ED with heart failure now with pneumonia


2nd room: 5 patients


• Elderly lady with TB now with resolving pneumonia, cachectic, ready for discharge today
• Young man with unusual pneumonia not resolving after antibiotic treatment, transferred from an OSH, with prior CD4 low found out today
• Middle-aged female with resolving pneumonia
• Elderly male with COPD now with SOB and elevated CRP, PMN, CPT (we'll get to why CPT is used in another post)
• Middle-aged male with COPD, emphysema now requiring facial mask ventilator with FiO2 drop over past 3 days from 70->40%


3rd room: 5 patients


• Elderly man with COPD, HTN now with fungal sepsis resolving and negative MDS by FISH
• Elderly female with COPD, HF now with respiratory failure on facial mask respirator; Also has thrush today
• Elderly female with COPD, chronic bronchitis now with pneumonia
• Elderly male with COPD, now with pneumonia
• Elderly male with COPD now with cough, failure to thrive


Last room: 10 patients


• Elderly man with COPD and severe pneumonia resolving
• Elderly man with COPD and TB now with cough, unintentional weight loss x4mo, new cavitary lung lesions bilaterally, elevated CRP, PCT
• Elderly man with COPD and resolving pneumonia
• Middle-aged female with TB now worsening
• Middle-aged female with low-grade fever x1mo, splenomegaly, elevated LFTs, pancytopenia awaiting bone marrow analysis and blood smear results
• Middle-aged man with COPD and bronchiectasis now with pneumonia resolving
• Young female with newly diagnosed TB
• Elderly female with COPD now with pneumonia and new left neck/ jaw pain today, possible dental infection
• Elderly male with COPD on facial mask ventilation now with fever, cough, SOB
• Elderly male with DM2, HTN, and recent ERCP 2d ago now with fever



There are also 13 respiratory ICU patients, most of whom require either ventilation by face mask or endotracheal intubation. Many of them are respiratory failure, post-surgical, or an amalgamation of heart/renal/liver failure contributing to poor ventilation.

Overall, COPD is highly prevalent due to high smoking rates, especially in older generations. Many patients develop pneumonia secondary to already susceptible lungs damaged by emphysema or chronic bronchitis from COPD. A few patients also present with symptoms that are worked up to be cancerous lesions and referred further to other departments for chemotherapy, radiation, and surgery. TB is also much more common than in the US, in patients across the age spectrum. Interestingly enough, these patients are not isolated from the rest even after diagnosis of TB by blood testing of IFN-gamma.

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