Pneumonia diagnostic criteria: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{CMG}}; | {{CMG}}; {{AE}} {{HQ}}, [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh13579@gmail.com] | ||
{{Pneumonia}} | {{Pneumonia}} | ||
==Overview== | ==Overview== | ||
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==Diagnostic Criteria== | ==Diagnostic Criteria== | ||
===Community- | ===Community-Acquired pneumonia=== | ||
Patient who has not been hospitalized or in an institutional setting for the past 2 weeks and have the following findings: | Patient who has not been hospitalized or in an institutional setting for the past 2 weeks and have the following findings: | ||
* CXR findings of a new infiltrate. Although there is no gold standard for the diagnosis of community acquired pneumonia (CAP), a new infiltrate on chest radiograph in the setting of acute respiratory complaints (e.g., cough and dyspnea) is considered highly suggestive of CAP. | * CXR findings of a new infiltrate. Although there is no gold standard for the diagnosis of community acquired pneumonia (CAP), a new infiltrate on chest radiograph in the setting of acute respiratory complaints (e.g., cough and dyspnea) is considered highly suggestive of CAP. | ||
* At least 2 of the four need to be present. The four symptoms are [[fever]], [[cough]], [[dyspnea]], chest pain. | * At least 2 of the four need to be present. The four symptoms are [[fever]], [[cough]], [[dyspnea]], chest pain. | ||
=== | ===Hospital Acquired Pneumonia=== | ||
According to the Infectious Diseases Society of America and the American Thoracic Society healthcare-associated pneumonia includes any patient who meet the below criteria <ref name="pmid21663884">{{cite journal |author=Attridge RT, Frei CR |title=Health care-associated pneumonia: an evidence-based review |journal=[[The American Journal of Medicine]] |volume=124 |issue=8 |pages=689–97 |year=2011 |month=August |pmid=21663884 |doi=10.1016/j.amjmed.2011.01.023 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(11)00291-9 |accessdate=2012-09-02}}</ref> | According to the Infectious Diseases Society of America and the American Thoracic Society healthcare-associated pneumonia includes any patient who meet the below criteria <ref name="pmid21663884">{{cite journal |author=Attridge RT, Frei CR |title=Health care-associated pneumonia: an evidence-based review |journal=[[The American Journal of Medicine]] |volume=124 |issue=8 |pages=689–97 |year=2011 |month=August |pmid=21663884 |doi=10.1016/j.amjmed.2011.01.023 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(11)00291-9 |accessdate=2012-09-02}}</ref> | ||
* Hospitalized in an acute care hospital for 2 or more days within 90 days of the infection; | * Hospitalized in an acute care hospital for 2 or more days within 90 days of the infection; | ||
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* Received recent intravenous antibiotic therapy, chemotherapy, or wound care within the past 30 days of the current infection; | * Received recent intravenous antibiotic therapy, chemotherapy, or wound care within the past 30 days of the current infection; | ||
* Attended a hospital or [[hemodialysis]] clinic. | * Attended a hospital or [[hemodialysis]] clinic. | ||
==Infectious Diseases Society of America/American Thoracic Society consensus recommendation criteria for severe community acquired pneumonia in adults. <ref name="pmid17278083">{{cite journal |author=Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Musher DM, Niederman MS, Torres A, Whitney CG |title=Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults |journal=[[Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America]] |volume=44 Suppl 2 |issue= |pages=S27–72 |year=2007 |month=March |pmid=17278083 |doi=10.1086/511159 |url=http://www.cid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=17278083 |accessdate=2012-09-06}}</ref> (DO NOT EDIT)== | |||
{{cquote| | |||
===Minor Criteria=== | |||
* Respiratory rate >30 breaths/min | |||
* PaO2/FiO2 ratio <250 | |||
* Multilobar infiltrates | |||
* [[Confusion]]/[[disorientation]] | |||
* [[Uremia]] ([[BUN]] level, >20 mg/dL) | |||
* [[Leukopenia]] (WBC count, <4000 cells/mm3) | |||
* [[Thrombocytopenia]] (platelet count, < 100,000 cells/mm3) | |||
* [[Hypothermia]] (core temperature, <36 degrees C) | |||
* [[Hypotension]] requiring aggressive fluid resuscitation | |||
===Major criteria=== | |||
* Invasive [[mechanical ventilation]] | |||
* [[Septic shock]] with the need for [[vasopressors]] | |||
}} | |||
==References== | ==References== | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
[[Category:Pneumonia|Pneumonia]] | [[Category:Pneumonia|Pneumonia]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
Latest revision as of 13:31, 29 March 2018
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]
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Pneumonia Microchapters |
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Diagnosis |
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Treatment |
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Risk calculators and risk factors for Pneumonia diagnostic criteria |
Overview
Community acquired pneumonia should be distinguished from healthcare-associated pneumonia as these diseases have different causative organism, prognosis, diagnostic and treatment guidelines.
Diagnostic Criteria
Community-Acquired pneumonia
Patient who has not been hospitalized or in an institutional setting for the past 2 weeks and have the following findings:
- CXR findings of a new infiltrate. Although there is no gold standard for the diagnosis of community acquired pneumonia (CAP), a new infiltrate on chest radiograph in the setting of acute respiratory complaints (e.g., cough and dyspnea) is considered highly suggestive of CAP.
- At least 2 of the four need to be present. The four symptoms are fever, cough, dyspnea, chest pain.
Hospital Acquired Pneumonia
According to the Infectious Diseases Society of America and the American Thoracic Society healthcare-associated pneumonia includes any patient who meet the below criteria [1]
- Hospitalized in an acute care hospital for 2 or more days within 90 days of the infection;
- Resided in a nursing home or long-term care facility;
- Received recent intravenous antibiotic therapy, chemotherapy, or wound care within the past 30 days of the current infection;
- Attended a hospital or hemodialysis clinic.
Infectious Diseases Society of America/American Thoracic Society consensus recommendation criteria for severe community acquired pneumonia in adults. [2] (DO NOT EDIT)
| “ |
Minor Criteria
Major criteria
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References
- ↑ Attridge RT, Frei CR (2011). "Health care-associated pneumonia: an evidence-based review". The American Journal of Medicine. 124 (8): 689–97. doi:10.1016/j.amjmed.2011.01.023. PMID 21663884. Retrieved 2012-09-02. Unknown parameter
|month=ignored (help) - ↑ Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Musher DM, Niederman MS, Torres A, Whitney CG (2007). "Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults". Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 44 Suppl 2: S27–72. doi:10.1086/511159. PMID 17278083. Retrieved 2012-09-06. Unknown parameter
|month=ignored (help)