Table 1.

Demographics, clinical characteristics, treatment, and outcomes

		Patient 1	Patient 2
Demographics
	Age, y	86	82
	Sex	Male	Male
	Ethnicity	White British	Pakistani
	Comorbidities	Alzheimer's disease, hypertension (HTN), and disseminated malignancy of unknown origin	Type 2 diabetes mellitus, ischemic cardiomyopathy, HTN, and chronic kidney disease
	Pneumococcal vaccination (PPSV23)	2005	2003
Clinical findings on admission
	Duration of symptom, d	2	2
	Chest X‐ray
Symptoms and initial observations
	Symptoms	Dyspnea, fever, and fatigue	Chest pain, fever, and cough
	Respiratory rate, breaths/min	24	22
	O2 saturation in room air (%)	92	95
	Temperature, °C	38	39
	Supine blood pressure, mm Hg	160/98	127/59
	Heart rate, beats/min	120	107
Initial laboratory results
	WCC (cells per 106/L)	2.01	14.5
	Lymphocyte (cells per 106/L)	0.19	0.8
	Platelets (cells per 106/L)	131	192
	Lactate dehydrogenase, U/L	396	149
	CRP, mg/dL	59	41
	D dimer, ng/mL		716
	Troponin, ng/mL	114	62
	Ferritin ng/mL	1237	788
	Blood culture organism	S. pneumoniae (serotype 38—not in any current pneumococcal vaccines)	S. pneumoniae (serotype 8—present in the 23‐valent plain polysaccharide vaccine but not in the 13‐valent conjugate vaccine)
	Sensitivities	Erythromycin Penicillin	Erythromycin Co‐trimoxazole Cefotaxime
Treatment and outcomes
	Other antibiotics	Amoxicillin Clarithromycin vancomycin	Amoxicillin Co‐amoxiclav
	Admitted to intensive care unit	No	No
	Invasive or noninvasive ventilation	No	CPAP
	Length of admission (nights)	15	21
	Outcome	Death	Discharged

Abbreviations: CPAP, continuous positive airway pressure; CRP, C‐reactive protein; WCC, white cell count.