An 82-Years-Old Woman with Diabetes Mellitus Type 2, Systemic Hypertension and Dyspnea, Admitted to Hospital with Right Lung Post Viral Pneumonia- A Case Report

Aim Presentation of a case with diabetes mellitus type 2 and viral pneumonia, in an old woman. Clinical case An 82-years old woman was brought to the emergency department with nausea, vomiting, fatigue, temperature, dyspnea and oliguria. The patient had a medical history of type 2 diabetes for five years and systemic hypertension for ten years, and she was under treatment with oral antidiabetic and antihypertensive drugs. Physical exam and Laboratory data The blood pressure was 200/100 mm Hg, the heart rate was 110 beats/minute, the respiratory rate 28/min. Temperature of 37.8C. The chest examination revealed tachypnea, decreased breath sounds, crackles in the bases of both lungs. Oxygen saturation was 78 %. The abdominal examination was unremarkable. She has edema of the lower extremities. Glucose=500mg/dl, Creatinine=1.47 mg/dl, AST=287 U/L, ALT=318U/L, Hepatic virus B and C antigens-negative. Brucellosis test, D-Dimer negative. Leukocytosis, first with left than right deviation of the leukocyte formula, high ESR and PCR. Thyroid function test not remarkable for hyperthyreosis. The urine, blood and culture were negative. Sputum stains and cultures were negative. The PPD test was negative. Chest X-ray indicated a dilated heart and bilateral pleural effusion. Computed tomographic (CT) scan of the chest showed pleural effusion and calcification in the right lung. Examination of the pleural fluid= exudate. Conclusion The diagnosis of viral pneumonia with bacterial superinfection of the right lung was given, relying on clinical feature and laboratory findings. The patient underwent treatment with Oxygen therapy, Fluids, Insulin, Antibiotics, Antiviral, Antyhepertensive and antimycotic drugs. She recovered after 14 days and discharged.