Bacterial pneumonia physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Bacterial pneumonia}} | {{Bacterial pneumonia}} | ||
'''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [Mailto:charlesmichaelgibson@gmail.com| <nowiki>[1]</nowiki>]; '''Associate Editor(s)-in-Chief:''' Arooj Naz<br /> | '''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [Mailto:charlesmichaelgibson@gmail.com| <nowiki>[1]</nowiki>]; '''Associate Editor(s)-in-Chief:''' [[User:AroojNaz|Arooj Naz, M.B.B.S]]<br /> | ||
==Overview== | ==Overview== | ||
Although physical examination may differ amongst patients, many | Although [[physical examination]] may differ amongst patients, many present with similar findings. Variations may be due to the severity and extent of disease, the causative bacteria, as well as the presence or absence of any [[Bacterial pneumonia natural history, complications and prognosis|complications]].<ref name="pmid30020693">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume= | issue= | pages= | pmid=30020693 | doi= | pmc= | url= }} </ref> Much of the systemic examination may appear to be normal, with the exception of some, in cases of specific [[infections]]. All patients present with significant pulmonary findings and changes in [[vital signs]]. With the development of [[complications]] such as [[sepsis]], [[neurological]] <nowiki/>findings such as [[confusion]] can also develop. | ||
==Physical Examination== | ==Physical Examination== | ||
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===Vital Signs=== | ===Vital Signs=== | ||
*Pulse: > 100/minute | *[[Pulse]]: > 100/minute | ||
*Temperature: > 38 C/100.4 F ''or'' < 35 C/95 F | *[[Temperature]]: > 38 C/100.4 F ''or'' < 35 C/95 F | ||
*Respiratory Rate: 18 breaths/minute | *[[Respiratory Rate]]: 18 breaths/minute | ||
===Examination According to Systems=== | ===Examination According to Systems=== | ||
====ENT==== | ====[[ENT]]==== | ||
*Dental illnesses may predispose to an ''[[Anaerobic organism|Anaerobic]]'' infection | *Dental illnesses may predispose to an ''[[Anaerobic organism|Anaerobic]]'' infection | ||
====Skin==== | ====[[Skin]]==== | ||
*Cyanosis may be present | *[[Cyanosis]] may be present | ||
====Cardiovascular==== | ====[[Cardiovascular]]==== | ||
*Tachycardia (> 100/minute) | *[[Tachycardia]] (> 100/minute) | ||
*Bradycardia may be found in cases of ''[[Legionella]]'' | *[[Bradycardia]] may be found in cases of ''[[Legionella]]'' | ||
====Pulmonary==== | ====[[Pulmonary]]==== | ||
*Breath sounds: bronchial breath sounds as well as crackles and rales | *[[Breath sounds]]: bronchial breath sounds as well as [[crackles]] and [[rales]] | ||
*Percussion: dull | *[[Percussion]]: dull | ||
*Egophony: increased | *[[Egophony]]: increased | ||
*Fremitus: tactile/ increased | *[[Fremitus]]: tactile/ increased | ||
*Tracheal Deviation: often absent | *Tracheal Deviation: often absent | ||
*Other findings: lymphadenopathy | *Other findings: lymphadenopathy | ||
====Neurological/ Psychological==== | ====[[Neurological]]/ [[Psychological]]==== | ||
*Patients may present with confusion, especially the elderly or patients that develop sepsis | *Patients may present with [[confusion]], especially the elderly or patients that develop [[sepsis]] | ||
====Renal==== | ====[[Renal]]==== | ||
*No significant findings | *No significant findings | ||
====GIT==== | ====[[GIT]]==== | ||
*Diarrhea may indicate a ''[[Legionella]]'' infection<ref name="pmid33110729">{{cite journal| author=Dalal N, Athwal PSS, Tharu B, Shah P, Shah L| title=Legionnaires Disease Presenting as Diarrhea: A Case Report. | journal=Cureus | year= 2020 | volume= 12 | issue= 9 | pages= e10593 | pmid=33110729 | doi=10.7759/cureus.10593 | pmc=7581213 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33110729 }} </ref> | *[[Diarrhea]] may indicate a ''[[Legionella]]'' infection<ref name="pmid33110729">{{cite journal| author=Dalal N, Athwal PSS, Tharu B, Shah P, Shah L| title=Legionnaires Disease Presenting as Diarrhea: A Case Report. | journal=Cureus | year= 2020 | volume= 12 | issue= 9 | pages= e10593 | pmid=33110729 | doi=10.7759/cureus.10593 | pmc=7581213 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33110729 }} </ref> | ||
====Muscular==== | ====[[Muscular]]==== | ||
*No significant findings; patients often complain of myopathy | *No significant findings; patients often complain of [[myopathy]] | ||
====Genitourinary==== | ====[[Genitourinary]]==== | ||
*No significant findings | *No significant findings | ||
====Hematological==== | ====[[Hematological]]==== | ||
*Hemolytic anemia may be seen with ''[[Mycoplasma]]'' infections<ref name="pmid22333470">{{cite journal| author=Han X, He B, Wang F| title=[Mycoplasma pneumonia associated with hemolytic anemia: case report and literature review]. | journal=Zhonghua Jie He He Hu Xi Za Zhi | year= 2011 | volume= 34 | issue= 11 | pages= 832-6 | pmid=22333470 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22333470 }} </ref> | *[[Hemolytic anemia]] may be seen with ''[[Mycoplasma]]'' infections<ref name="pmid22333470">{{cite journal| author=Han X, He B, Wang F| title=[Mycoplasma pneumonia associated with hemolytic anemia: case report and literature review]. | journal=Zhonghua Jie He He Hu Xi Za Zhi | year= 2011 | volume= 34 | issue= 11 | pages= 832-6 | pmid=22333470 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22333470 }} </ref> | ||
==References== | ==References== | ||
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[[Category:Pneumonia|Pneumonia]] | [[Category:Pneumonia|Pneumonia]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category: | [[Category:Up to Date]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 18:11, 14 July 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S
Overview
Although physical examination may differ amongst patients, many present with similar findings. Variations may be due to the severity and extent of disease, the causative bacteria, as well as the presence or absence of any complications.[1] Much of the systemic examination may appear to be normal, with the exception of some, in cases of specific infections. All patients present with significant pulmonary findings and changes in vital signs. With the development of complications such as sepsis, neurological findings such as confusion can also develop.
Physical Examination
General Appearance
Patients may appear normal or in distress. Varying degrees of cyanosis may be present.
Vital Signs
- Pulse: > 100/minute
- Temperature: > 38 C/100.4 F or < 35 C/95 F
- Respiratory Rate: 18 breaths/minute
Examination According to Systems
ENT
- Dental illnesses may predispose to an Anaerobic infection
Skin
- Cyanosis may be present
Cardiovascular
- Tachycardia (> 100/minute)
- Bradycardia may be found in cases of Legionella
Pulmonary
- Breath sounds: bronchial breath sounds as well as crackles and rales
- Percussion: dull
- Egophony: increased
- Fremitus: tactile/ increased
- Tracheal Deviation: often absent
- Other findings: lymphadenopathy
Neurological/ Psychological
Renal
- No significant findings
GIT
- Diarrhea may indicate a Legionella infection[2]
Muscular
- No significant findings; patients often complain of myopathy
Genitourinary
- No significant findings
Hematological
- Hemolytic anemia may be seen with Mycoplasma infections[3]
References
- ↑ "StatPearls". 2021. PMID 30020693.
- ↑ Dalal N, Athwal PSS, Tharu B, Shah P, Shah L (2020). "Legionnaires Disease Presenting as Diarrhea: A Case Report". Cureus. 12 (9): e10593. doi:10.7759/cureus.10593. PMC 7581213 Check
|pmc=value (help). PMID 33110729 Check|pmid=value (help). - ↑ Han X, He B, Wang F (2011). "[Mycoplasma pneumonia associated with hemolytic anemia: case report and literature review]". Zhonghua Jie He He Hu Xi Za Zhi. 34 (11): 832–6. PMID 22333470.