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Clinical case review
A woman with a cough not responding to routine antibiotics
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Lung diseases
Lung diseases
Abstract
What diagnoses should be considered in this patient, whose respiratory symptoms have failed to respond to routine antibiotic therapy? How should she now be investigated and managed?
Key Points
Case scenario
Jiesi, a 27-year-old woman from China, presented with a cough that had been troubling her for the past fortnight. She is studying accountancy at a private college in the centre of Sydney and she lives with her husband and 18-month-old daughter. One week before presenting, she noticed shortness of breath and then developed right-sided chest pain. She was taking no regular medications and she is a nonsmoker.
The patient’s temperature was 38.6oC, so she was prescribed antibiotics (amoxycillin and roxithromycin) for suspected community-acquired pneumonia (CAP).
After a week of treatment there was no change in her condition so a chest x-ray was performed (Figure).
Why has Jiesi not improved on the prescribed antibiotics?