An 80-year-old lady with a history of chronic obstructive pulmonary disease and heart failure is admitted via her GP with a 2-day history of cough and fever with a suspicion of a pneumonia. Her chest X-ray shows a right lower lobe pneumonia

a. Pneumococcal pneumonia is the commonest bacterial pneumonia affecting all ages but is especially common in the elderly. Other groups commonly affected are alcoholics, patients after splenectomy, immunosuppressed patients and patients with chronic heart failure or those with pre-existing lung disease. Patients usually complain of fever and pleurisy. A classical chest X-ray appearance is one of a lobar pneumonia.