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{{Pneumonia}}
{{Pneumonia}}
'''Editor(s)-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto:mgibson@perfuse.org] Phone:617-632-7753; [[Philip Marcus, M.D., M.P.H.]][mailto:pmarcus192@aol.com]
{{CMG}}; {{AE}} {{HQ}}, [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh13579@gmail.com]


==Overview==
==Overview==
People with pneumonia often have a productive [[cough]], [[fever]], [[rigors|chills]], [[shortness of breath]], pleuritic [[chest pain]], [[hemoptysis]], [[headache]]s, [[diaphoresis]], and clammy [[skin]]. Other possible symptoms are [[anorexia (symptom)|loss of appetite]], [[fatigue]], [[cyanosis]], [[nausea]], [[vomiting]], mood swings, and [[arthralgia|joint pains]] or [[myalgia|muscle aches]].  In elderly people manifestations of pneumonia may not be typical. They may develop a new or worsening confusion or may experience unsteadiness, leading to falls.  Infants with pneumonia may have many of the symptoms previously mentioned, but in many cases they are [[lethargic]] or have a decreased [[appetite]].


==Symptoms==
==History and Symptoms==
[[Image:New Pneumonia cartoon.jpg|thumb|250px|'''Pneumonia''' fills the lung's [[alveolus|alveoli]] with fluid, keeping oxygen from reaching the bloodstream. The alveolus on the left is normal, while the alveolus on the right is full of fluid from pneumonia.]]
{| style="float:right"
People with infectious pneumonia often have a cough producing greenish or yellow [[sputum]] and a high [[fever]] that may be accompanied by [[rigors|shaking chills]].
|[[Image:New Pneumonia cartoon.jpg|thumb|center|250px|'''Pneumonia''' fills the lung's [[alveolus|alveoli]] with fluid, keeping oxygen from reaching the bloodstream. The alveolus on the left is normal, while the alveolus on the right is full of fluid from pneumonia.]]
|}
===Common Symptoms <small><small><ref name="MusherThorner2014">{{cite journal|last1=Musher|first1=Daniel M.|last2=Thorner|first2=Anna R.|title=Community-Acquired Pneumonia|journal=New England Journal of Medicine|volume=371|issue=17|year=2014|pages=1619–1628|issn=0028-4793|doi=10.1056/NEJMra1312885}}</ref><ref>{{cite web|url=http://www.who.int/mediacentre/factsheets/fs331/en/|title= WHO Pneumonia Fact Sheets}}</ref><ref name="MandellWunderink2007">{{cite journal|last1=Mandell|first1=L. A.|last2=Wunderink|first2=R. G.|last3=Anzueto|first3=A.|last4=Bartlett|first4=J. G.|last5=Campbell|first5=G. D.|last6=Dean|first6=N. C.|last7=Dowell|first7=S. F.|last8=File|first8=T. M.|last9=Musher|first9=D. M.|last10=Niederman|first10=M. S.|last11=Torres|first11=A.|last12=Whitney|first12=C. G.|title=Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults|journal=Clinical Infectious Diseases|volume=44|issue=Supplement 2|year=2007|pages=S27–S72|issn=1058-4838|doi=10.1086/511159}}</ref><ref>{{cite web|url=http://www.niaid.nih.gov/topics/pneumonia/Pages/default.aspx| title=National Institute of Allergy and Infectious Diseases - Pneumococcal Pneumonia}}</ref></small></small>===
* [[Dyspnea]]
* [[Cough|Productive cough]] (greenish or yellow [[sputum]]). If a cough persists for 2 eeks or more, consider [[chlamydia pneumoniae]], [[mycoplasma pneumoniae]], or [[bordetella pertussis]].
* [[Fever]] (high grade) with sweating, chills, and [[rigor]]
* Pleuritic [[chest pain]]
* Rapid, shallow breathing
* [[Shortness of breath]]


[[Shortness of breath]] is also common, as is pleuritic [[chest pain]], a sharp or stabbing pain, either felt or worse during deep breaths or coughs. People with pneumonia may [[hemoptysis|cough up blood]], experience [[headache]]s, or develop [[diaphoresis|sweaty]] and clammy skin.
===Less Common Symptoms===
* [[Anorexia]]
* [[Arthralgia]]  
* [[Cyanosis]]
* [[Diarrhea]]
* [[Fatigue]]
* [[Headache]]s  
* [[Hemoptysis]]
* [[Myalgia]]
* [[Nausea]]
* [[Vomiting]]


Other possible symptoms are [[anorexia (symptom)|loss of appetite]], fatigue, [[cyanosis|blueness of the skin]], [[nausea]], [[vomiting]], mood swings, and[[arthralgia|joint pains]] or [[myalgia|muscle aches]].
===Elderly===
The manifestations of pneumonia might not be typical in older people. They may instead experience:
* [[Delirium]]
* Falls
* [[Hypothermia]]
*[[Altered mental status]]


Less common forms of pneumonia can cause other symptoms; for instance, pneumonia caused by ''[[Legionella]]'' may cause abdominal pain and [[diarrhea]], while pneumonia caused by [[tuberculosis]] or ''[[Pneumocystis jiroveci|Pneumocystis]]'' may cause only [[weight loss]] and [[Sleep hyperhidrosis|night sweats]].
===Infant===
* Increased sleepiness
* [[Jaundice]]
* Feeding difficulties{{ref|Metaly}}


In elderly people manifestations of pneumonia may not be typical. They may develop a new or worsening confusion or may experience unsteadiness, leading to falls. Infants with pneumonia may have many of the symptoms above, but in many cases they are simply sleepy or have a decreased appetite.
===Atypical Pneumonia===
* Subacute presentation, [[diarrhea]], and [[myalgias]]
 
==Community Acquired Pneumonia==
===History===
Important components in a patient's history when he/she is presenting with symptoms suggestive of pneumonia include:
* Duration of symptoms
* [[Fever]] pattern
* [[Cough|Productive]] or dry [[cough]]. If a cough persists for 2 eeks or more, consider [[chlamydia pneumoniae]], [[mycoplasma pneumoniae]], or [[bordetella pertussis]].
* Characteristics of [[sputum]]
* Presence of [[chest pain]]
* Presence of [[hemoptysis]]
* Recent sick contacts
* Travel history
* [[Smoking]] history
* History of other [[Lung|pulmonary]] conditions
* Recent hospital/health-care facility admission
* [[Antibiotic]] use
 
===Symptoms===
 
====Common Symptoms====
*The common features of community acquired pneumonia are:
#[[Fever]]
#[[Cough]]
#[[Chest pain]] mainly [[pleuritic]] type
#[[Dyspnea]]
#Sputum production
*Sputum color may help in detecting the causative agent of the pneumonia.
#[[Mucopurulent]] is a typical feature suggesting bacterial etiology
#Watery or clear fluid points out towards atypical [[bacteria]] and [[virus]].
#Rusty colored [[sputum]] is more typical of [[Streptococcus pneumoniae|pneumococcal]] pneumonia.
#Rapid, shallow breathing
====Atypical or uncommon symptoms====
*The other atypical or less common features of pneumonia are:<ref name="Marrie-1994">{{Cite journal  | last1 = Marrie | first1 = TJ. | title = Community-acquired pneumonia. | journal = Clin Infect Dis | volume = 18 | issue = 4 | pages = 501-13; quiz 514-5 | month = Apr | year = 1994 | doi =  | PMID = 8038304 }}</ref>
#[[Fever]] with [[chills]] or [[rigors]]
#Other system may also be involved like gastrointestinal which present with nausea, vomiting and diarrhea.
#If pneumonia is very severe the patient may also have altered consciousness.
* [[Anorexia]]
* [[Arthralgia]]
* [[Cyanosis]]
* [[Fatigue]]
* [[Headache]]s
* [[Hemoptysis]]
* [[Myalgia]]
 
====Elderly====
The manifestations of pneumonia, like those for many conditions, might not be typical in older people. They may instead experience:
*Confusion<ref name="Waterer-2006">{{Cite journal  | last1 = Waterer | first1 = GW. | last2 = Kessler | first2 = LA. | last3 = Wunderink | first3 = RG. | title = Delayed administration of antibiotics and atypical presentation in community-acquired pneumonia. | journal = Chest | volume = 130 | issue = 1 | pages = 11-5 | month = Jul | year = 2006 | doi = 10.1378/chest.130.1.11 | PMID = 16840376 }}</ref>
* [[Delirium]]
* Falls
* [[Hypothermia]]
 
====Infant====
* Increased sleepiness
* [[Jaundice]]
* Feeding difficulties{{ref|Metaly}}
 
==Hospital Acquired Pneumonia==
===Common Symptoms===
* [[Dyspnea]]
* [[Cough|Productive cough]] (greenish or yellow [[sputum]])
* [[Fever]] (high grade) with sweating, chills, and [[rigor]]
* Pleuritic [[chest pain]]
* Rapid, shallow breathing
 
===Less Common Symptoms===
* [[Hemoptysis]]
* [[Headache]]s
* [[Anorexia]]
* [[Fatigue]]
* [[Cyanosis]]
* [[Nausea]]
* [[Vomiting]]
* [[Diarrhea]]
* [[Arthralgia]]
* [[Myalgia]]
 
===Elderly===
The manifestations of pneumonia, like those for many conditions, might not be typical in older people. They might instead experience:
* [[Delirium]]
* [[Hypothermia]]
* Falls
 
===Infant===
* Increased sleepiness
* [[Jaundice]]
* Feeding difficulties{{ref|Metaly}}
===Atypical Pneumonia===
* Subacute presentation, [[diarrhea]], and [[myalgias]]


==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WS}}


[[Category:Diseaase]]
[[Category:Pneumonia]]
[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Infectious disease]]
[[Category:Pneumonia|Pneumonia]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
 
[[Category:Pediatrics]]
{{WH}}
[[Category:Disease]]
{{WS}}

Latest revision as of 23:45, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Priyamvada Singh, M.D. [3]

Overview

People with pneumonia often have a productive cough, fever, chills, shortness of breath, pleuritic chest pain, hemoptysis, headaches, diaphoresis, and clammy skin. Other possible symptoms are loss of appetite, fatigue, cyanosis, nausea, vomiting, mood swings, and joint pains or muscle aches. In elderly people manifestations of pneumonia may not be typical. They may develop a new or worsening confusion or may experience unsteadiness, leading to falls. Infants with pneumonia may have many of the symptoms previously mentioned, but in many cases they are lethargic or have a decreased appetite.

History and Symptoms

Pneumonia fills the lung's alveoli with fluid, keeping oxygen from reaching the bloodstream. The alveolus on the left is normal, while the alveolus on the right is full of fluid from pneumonia.

Common Symptoms [1][2][3][4]

Less Common Symptoms

Elderly

The manifestations of pneumonia might not be typical in older people. They may instead experience:

Infant

Atypical Pneumonia

Community Acquired Pneumonia

History

Important components in a patient's history when he/she is presenting with symptoms suggestive of pneumonia include:

Symptoms

Common Symptoms

  • The common features of community acquired pneumonia are:
  1. Fever
  2. Cough
  3. Chest pain mainly pleuritic type
  4. Dyspnea
  5. Sputum production
  • Sputum color may help in detecting the causative agent of the pneumonia.
  1. Mucopurulent is a typical feature suggesting bacterial etiology
  2. Watery or clear fluid points out towards atypical bacteria and virus.
  3. Rusty colored sputum is more typical of pneumococcal pneumonia.
  4. Rapid, shallow breathing

Atypical or uncommon symptoms

  • The other atypical or less common features of pneumonia are:[5]
  1. Fever with chills or rigors
  2. Other system may also be involved like gastrointestinal which present with nausea, vomiting and diarrhea.
  3. If pneumonia is very severe the patient may also have altered consciousness.

Elderly

The manifestations of pneumonia, like those for many conditions, might not be typical in older people. They may instead experience:

Infant

Hospital Acquired Pneumonia

Common Symptoms

Less Common Symptoms

Elderly

The manifestations of pneumonia, like those for many conditions, might not be typical in older people. They might instead experience:

Infant

Atypical Pneumonia

References

  1. ↑ Musher, Daniel M.; Thorner, Anna R. (2014). "Community-Acquired Pneumonia". New England Journal of Medicine. 371 (17): 1619–1628. doi:10.1056/NEJMra1312885. ISSN 0028-4793.
  2. ↑ "WHO Pneumonia Fact Sheets".
  3. ↑ Mandell, L. A.; Wunderink, R. G.; Anzueto, A.; Bartlett, J. G.; Campbell, G. D.; Dean, N. C.; Dowell, S. F.; File, T. M.; Musher, D. M.; Niederman, M. S.; Torres, A.; Whitney, C. G. (2007). "Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults". Clinical Infectious Diseases. 44 (Supplement 2): S27–S72. doi:10.1086/511159. ISSN 1058-4838.
  4. ↑ "National Institute of Allergy and Infectious Diseases - Pneumococcal Pneumonia".
  5. ↑ Marrie, TJ. (1994). "Community-acquired pneumonia". Clin Infect Dis. 18 (4): 501–13, quiz 514-5. PMID 8038304. Unknown parameter |month= ignored (help)
  6. ↑ Waterer, GW.; Kessler, LA.; Wunderink, RG. (2006). "Delayed administration of antibiotics and atypical presentation in community-acquired pneumonia". Chest. 130 (1): 11–5. doi:10.1378/chest.130.1.11. PMID 16840376. Unknown parameter |month= ignored (help)

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