Case Study

Case Study

Introduction

Frank Gellar is a patient that has suffered from road traffic injury and brought to the hospital in a serious condition. The patient has predominantly shown liver and spleen lacerations and further developed Ventilator associated pneumonia due to Methicillin-resistant S. Aureus (MRSA) infection. The patient's health deteriorated with an increase in Blood urea nitrogen and creatinine level, followed by oral Candida infection.

This case study studies different factors that are responsible for causing the occurrence of MRSA and VAP in the patient. It also defines the significance of MRSA in hospitals and the reasons behind the occurrence of Candida infection in the patient.

Discussion

Analyzing Case Background

In the given case, Mister Frank Gellar has been hospitalized due to the laceration of liver and spleen that is caused by an accident. The patient did not suffer from any history of pneumonia, and the ventilator associated pneumonia had been found to occur when the patient was intubated.

Question 1

Pneumonia is a condition which is characterized by inflammation of lungs. This disease is further categorized on the basis of the type of occurrence and the organisms that elicit the problem. Frank Gellar's case is an example of ventilator acquired pneumonia which is a subtype of nosocomial pneumonia.

Nosocomial Pneumonia and Ventilator Acquired Pneumonia

Nosocomial pneumonia is defined as the pneumonia that occurs within 48 hours of hospital admission (American Thoracic Society, 2004).it is one of the most serious types of pneumonia which occurs predominantly in elderly and immunocompromised patients. If pneumonia occurs in the patients that are receiving mechanical support of a ventilator, it is termed as ventilator associated pneumonia. It occurs when tracheostomy is performed in patients that are in critical care. The infection occurs when the microorganisms invades the lower respiratory tract. The condition is further aggravated when intubation allows the oral and gastric content to enter the trachea, due to compromised the integrity of oropharynx (Amanullah, Mosenifar, 2013). Ventilator associated pneumonia (VAP) remains to be a major challenge for the health care facilities. It is responsible for the increasing rates of morbidity and mortality as well as the increment in patient's length of hospital stay.

Preventing VAP starts around then of intubation and may as well proceed until extubation (American Thoracic Society, 2004). However, in many patients who have hospital acquired pneumonia, ventilation may be necessary and the preventive measures for VAP, therefore, becomes an essentiality. The treatment of VAP depends on the causative agents. In Frank Gellar's case, the cause of VAP has been found to be Methicillin-resistant S. Aureus (MRSA) infection. This indicates that the patient is suffering from nosocomial pneumonia.

Factors Decreasing Resistance to Infection

There are various factors that are associated with acquiring of ventilator associated pneumonia in in-hospital patients. As frank Gellar is a victim of road traffic accident, it is obvious that the patient is the victim of road traffic accident and is suffering from multi organ damage. Multi organ damage is responsible for reducing the patient immunity, and hence decreases the resistance towards the foreign microorganisms attacking the system (Weinstein, Bonten, ...