infection. These conditions that can lower a person's resistance to this type of
pneumonia include viral respiratory diseases, malnutrition, exposure to cold, exposure
to noxious gases, and alcoholic intoxication.
(a) Mild nasopharyngitis (inflammation of the nasopharynx)--several
days before onset of the disease.
(b) Sudden onset of illness.
Severe chest pain (occurs in 70 percent of the cases).
(e) Productive cough with rusty sputum.
Fever (103F to 106F) and chills.
(g) Often acutely ill.
(h) Dyspnea (labored breathing) and cyanosis. Cyanosis in light-
skinned individuals gives a bluish cast to skin, lips, and nail beds. In dark-skinned
individuals or blacks, the discoloration is grey or grayish. The cause is not enough
oxygen in the blood.
Decreased movement on one side of the chest.
Severe, shaking chill.
(k) Signs of consolidation (inflammatory solidification of the lung); dull
to percussion; bronchial breath sounds; fine rales.
(l) Gram-positive diplococci (bacterium which has not separated but
occurs in pairs as a result of disease).
(m) Blood culture positive.
(n) Chest x-rays originally showing vague haziness but later showing
shadows in area of lung involvement.
(2) Course. Fever and symptoms subside dramatically within 72 hours after
the start of the antibiotics in over fifty percent of the patients. When the patient begins
to get better, the fine rales and tubular breathing become coarse, sticky rales. If the
patient experiences pseudocrisis (the fever subsides, but the other symptoms continue),
watch for shock.