[Solved]: Friday, the day before Ann was readmitted, Brenda, a…

Friday, the day before Ann was readmitted, Brenda, a 76-year-old female, presented to the same emergency department with fever and shortness of breath. Only 24 hours ago (Thursday), she was discharged from the hospital after being treated for an infectious-exacerbation of asthma. During her prior stay, she was treated with amoxicillin and recovered from her previous illness. Her previous hospital stay overlapped with Ann’s by 36 hours. Brenda also tests positive for pneumococcal pneumonia and bacteremia. Donna, 72, has end-stage chronic obstructive pulmonary disease (COPD) and heart failure. She has been in the hospital continuously for 11 days prior to the readmission of Ann. When admitted, Donna had a negative sputum culture, and inflammatory markers were not raised. However, 8 days ago (the previous Friday), she developed an acute pneumonia with a sudden onset of fever. Her shortness of breath worsened and she developed a bloody cough. Her blood pressure dropped, her blood lactate levels rose to 5.3 mmol/L, and her C-reactive protein rose to over 300 mg/liter. Lab results indicated pneumococcal septicemia and pneumonia. Despite treatment, she died Friday (the day before Ann was admitted). Charlie, a 73-year-old male, had been visiting his wife, Donna, in the hospital daily since she was admitted. Charlie also has chronic obstructive pulmonary disease (COPD). Four days ago, he developed a chills and a high fever with shortness of breath and pain while breathing. All patients tested positive for S. pneumoniae. In all four patients, the strain of S. pneumoniae displayed indistinguishable antibiotic sensitivity results. Donna, Brenda, and Ann were all on the same floor of the hospital for their previous complications with asthma or COPD. Upon readmission (or upon worsening condition), they were moved to the intensive care unit (ICU). After Charlie was admitted, he placed in a room next to his wife (Donna). Ann, Brenda, and Charlie made recoveries with treatment and were discharged home.