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The usual clinical features of community-acquired pneumonia are very familiar. Symptoms include fever, cough (usually productive of purulent sputum), shortness of breath, and chest pain (often described as pleuritic). Symptoms are typically rapid in onset, with most patients presenting within the first few days of symptoms. Patients may experience chills or rigors. Nonspecific symptoms are also common, such as headache, fatigue, myalgias, and occasionally abdominal pain.Clinical signs of pneumonia include fever, tachycardia, tachypnea, and abnormal breath sounds. Focal crackles, egophony, increased tactile fremitus, and wheezes are the most common physical examination findings associated with pneumonia.Although these signs and symptoms are identified in most patients, atypical presentations occur, especially in elderly or immunosuppressed patients. Among these patients, pneumonia may occur without signs or symptoms localizing to the chest and without fever. Elderly patients may be found with mental status changes, failure to thrive, abdominal Pain, or exacerbation of underlying chronic diseases. Tachypnea (respiratory rate exceeding 26 breaths/minute) may suggest pneumonia in the elderly patient without other obvious clinical features of pneumonia, and this may be the only clinical clue to the diagnosis.*40/348/5*
Chicken pox is a common childhood disease caused by a virus. From ten to twenty days after exposure the symptoms begin with mild headache, loss of appetite and fever. Then after thirty-six hours the eruption appears. The rash usually is seen on the body and later on the face, neck, and extremities. Little red pinpoints enlarge to papules which change to blisters or vesicles. After a few days these break and are covered by dark brown crusts. The spots may become secondarily infected from scratching and pus infection will leave scars.
Chicken pox requires little treatment except to keep the areas free from secondary infection. The fingernails of children should be kept trimmed short. The itching is controllable by a calamine lotion containing one per cent of menthol or of phenol. If secondary infection occurs, antibiotic ointments will stop the spread. Chicken pox seems to be related to the nerve condition causing blisters known as herpes zoster. The common name for herpes zoster is “shingles.”
*9/318/5*