Can pneumonia been mistaken for a stroke?

[Emma-Louise]

My father was recently taken to hospital after collapsing.  His condition was described to us as a "catastrophic event in his brain" such as a stroke or a bleed.  The hospital advised us not to make him uncomfortable with tests and scans, but to accept the fact he was dying and spend time with him.  Consequently he received very passive care, never regained consciousness and passed away after 24 hours.

As my father was suffering after radiotherapy for cancer that had severely affected his quality of life, we agreed.  We were worried that we would bring him back to brain damage as well as the pain he was suffering.

However, the post mortem has subsequently revealed that he actually had pneumonia and there was no evidence of stroke or a bleed.  

My father was incredibly bright and cheerful only 4 hours earlier, so I dont understand how this can happen so quickly and how so many doctors can have missed the condition.

The family are now very upset and worried we gave up on him too quickly. To make matters worse the post mortem has revealed that the cancer had gone - and the threat of cancer was the primary reason for the passive care.

Any help or advice anyone can give would be greatly appreciated.

Many thanks
Emma

[National Jewish]

I am sorry to hear of your loss, especially under such circumstances.

Some types of pneumonia can have an explosive onset.  If large numbers of bacteria are released into the blood stream, sudden collapse can be the first sign.  That your father was "incredibly bright and cheerful only 4 hours earlier" is more suggestive of a stroke than of pneumonia.  It is understandable that his collapse and the drastic change in his neurologic condition could have been mistakenly assumed to be due to a stroke.

In retrospect, "tests and scans" might have helped the doctors to find the pneumonia.  On the other hand, pneumonia this virulent superimposed on radiotherapy would be associated with a high mortality rate.  Your father might well have died, even if the pneumonia had been found and treated with antibiotics and intensive supportive care.

Please do not feel guilty.  You obviously loved your father.  Your acceptance of the advice offered by his doctors was made in what you deemed to be your father's best interest.  Even so, you should discuss your regrets and misgivings with his doctors.  Ask each of them how, "so many doctors can have missed the condition."

[AndyRRT]

I'm sorry to hear about your dad. But the answer to your question is no. A stroke and pneumonia are two completely different ailments that involve two different areas of the body. Strokes and bleeds occur in the brain, and pneumonias involve only the lungs.

The only way to diagnose a stroke or bleed would be with tests like a cat-scan or MRI. Other symptoms such as muscle weakness, being obtunded, and facial drooping can only strengthen suspicions but not be marked diagnosis.

The only thing I can think of that may have masked a possible stroke or bleed was severe hypoxia that caused anoxia. I'm not sure if starving the brain of vital oxygen shows up when its autotopsied.

again, I'm sorry to hear about your dad.

Andy,RRT,CPFT

[Ellis7]

Your post raises some questions:
*What did the hospital list as the cause of death?
*Was he put on a respirator during his 24 hr in the hospital?
*What tests were run to determine he had a catastrophic untreatable event? Was a 2nd opinion offered?
*What type of pneumonia was diagnosed--aspiration pneumonia?
bacterial? viral?
*Have you received a copy of his medical record while in the hospital?
*How old was he? What type of cancer?

If the hospital can't provide satisfactory answers, you might want to consider consulting a medical malpractice attorney to get to the bottom of what happened; or the Medical Licensing Board in your state.

[roxana181]

A related discussion, can pneumonia be mistaken for panic attacks was started.