Pneumonia physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
[[Physical examination]]may reveal [[fever]] or sometimes [[hypothermia|low body temperature]], an [[tachypnea|increased respiratory rate]], [[hypotension|low blood pressure]], a [[tachycardia|fast heart rate]], or a low [[oxygen saturation]], which is the amount of oxygen in the blood as indicated by either [[pulse oximetry]] or [[arterial blood gas|blood gas analysis]]. | [[Physical examination]] may reveal [[fever]] or sometimes [[hypothermia|low body temperature]], an [[tachypnea|increased respiratory rate]], [[hypotension|low blood pressure]], a [[tachycardia|fast heart rate]], or a low [[oxygen saturation]], which is the amount of oxygen in the blood as indicated by either [[pulse oximetry]] or [[arterial blood gas|blood gas analysis]]. Patients who are struggling to breathe, who are confused, or who have [[cyanosis]] (blue-tinged skin) require immediate attention. [[Auscultation]] findings include lack of normal breath sounds, the presence of crackling sounds ([[rales]]), or increased loudness of whispered speech (whispered pectoriloquy) with areas of the lung that are stiff and full of fluid, called consolidation. Vital signs are useful in determining the severity of illness and have predictive values. However, a high degree of suspicion should be kept in elderly as the presentation could be subtle in them. | ||
==Physical Examination<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></small></small>== | ==Physical Examination<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></small></small>== |
Revision as of 18:50, 6 November 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyamvada Singh, M.D. [2]
Overview
Physical examination may reveal fever or sometimes low body temperature, an increased respiratory rate, low blood pressure, a fast heart rate, or a low oxygen saturation, which is the amount of oxygen in the blood as indicated by either pulse oximetry or blood gas analysis. Patients who are struggling to breathe, who are confused, or who have cyanosis (blue-tinged skin) require immediate attention. Auscultation findings include lack of normal breath sounds, the presence of crackling sounds (rales), or increased loudness of whispered speech (whispered pectoriloquy) with areas of the lung that are stiff and full of fluid, called consolidation. Vital signs are useful in determining the severity of illness and have predictive values. However, a high degree of suspicion should be kept in elderly as the presentation could be subtle in them.
Physical Examination[1][2][3]
Vital Signs
- Decreased oxygen saturation
- Fever
- Hypotension < 90 mm Hg
- Tachycardia > 125 beats/min
- Tachypnea
Lungs
Palpation
- Increased tactile fremitus
Percussion
- Dullness on percussion
Auscultation
- Decreased breath sounds
- Bronchial breath sounds
- Rhonchi
- Crackles, Rales
- Increased volume of whispered (vocal fremitus).
References
- ↑ 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.
- ↑ "WHO Pneumonia Fact Sheets".
- ↑ 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.