Pneumonia diagnostic algorithm: Difference between revisions
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Shown below is an algorithm for the diagnostic approach of pneumonia.<ref name="cid.oxfordjournals.org">{{Cite web | last = | first = | title = http://cid.oxfordjournals.org/content/44/Supplement_2/S27.full.pdf+html | url = http://cid.oxfordjournals.org/content/44/Supplement_2/S27.full.pdf+html | publisher = | date = | accessdate = 13 March 2014 }}</ref><ref name="www.nejm.org">{{Cite web | last = | first = | title = MMS: Error | url = http://www.nejm.org/doi/full/10.1056/NEJMcp1214869 | publisher = | date = | accessdate = }}</ref> | Shown below is an algorithm for the diagnostic approach of pneumonia.<ref name="cid.oxfordjournals.org">{{Cite web | last = | first = | title = http://cid.oxfordjournals.org/content/44/Supplement_2/S27.full.pdf+html | url = http://cid.oxfordjournals.org/content/44/Supplement_2/S27.full.pdf+html | publisher = | date = | accessdate = 13 March 2014 }}</ref><ref name="www.nejm.org">{{Cite web | last = | first = | title = MMS: Error | url = http://www.nejm.org/doi/full/10.1056/NEJMcp1214869 | publisher = | date = | accessdate = }}</ref> | ||
<small>'''Abbreviations:''' HCAP: Healthcare-associated Pneumonia </small> | |||
<div style= font-size:85%> | |||
{{familytree/start}} | {{familytree/start}} | ||
{{familytree | | | | | | | | | A01 | | | | | | | | | | | | | | | | | A01=<div style="float: left; text-align: left; width: | {{familytree | | | | | | | | | A01 | | | | | | | | | | | | | | | | | A01=<div style="float: left; text-align: left; width: 20em; padding:1em;"> '''Respiratory Tract Infection Symptoms:'''<br>❑ [[Fever]] <br>❑ [[Cough]] with sputum <br>❑ [[Dyspnea]]<br>❑ [[Pleuritic]] chest pain</div> }} | ||
{{familytree | | | | | | | | | |!| | | | | | | | | | | | | | | | | | }} | {{familytree | | | | | | | | | |!| | | | | | | | | | | | | | | | | | }} | ||
{{familytree | | | | | | | | | B01 | | | | | | | | | | | | | | | | | B01=<div style="float: left; text-align: left; width: | {{familytree | | | | | | | | | B01 | | | | | | | | | | | | | | | | | B01=<div style="float: left; text-align: left; width: 20em; padding:1em;">'''Physical Examination:''' <br> | ||
❑ [[Fever]] | ❑ [[Fever]] <br> | ||
❑ [[Tachypnea]] | ❑ [[Tachypnea]] <br> | ||
❑ | ❑ [[Tachycardia]] <br> | ||
❑ [[Percussion|Dull percussion]] on affected side<br> | ❑ [[Percussion|Dull percussion]] on affected side<br> | ||
❑ [[Breath sounds|Bronchial breath sounds]]<br> | ❑ [[Breath sounds|Bronchial breath sounds]]<br> | ||
❑ [[Rales]] and/or <br>❑ [[Vocal fremitus|Increased vocal fremitus]] <br> | ❑ [[Rales]] and/or <br> | ||
❑ [[Vocal fremitus|Increased vocal fremitus]] <br> | |||
❑ [[Whispered pectoriloquy]]<br> | ❑ [[Whispered pectoriloquy]]<br> | ||
❑ [[Pleural friction rub]]</div>}} | ❑ [[Pleural friction rub]]</div>}} | ||
{{familytree | | | | | | | | | |!| | | | | | | | | | | | | | | | | | }} | {{familytree | | | | | | | | | |!| | | | | | | | | | | | | | | | | | }} | ||
{{familytree | | | | | | | | | C01 | | | | | | | | | | | | | | | | | C01=<div style="float: left; text-align: left; width: | {{familytree | | | | | | | | | C01 | | | | | | | | | | | | | | | | | C01=<div style="float: left; text-align: left; width: 20em; padding:1em;">'''Order Labs:'''<br> ❑ [[Complete blood count]] (CBC) <br>❑ [[Blood urea nitrogen]] (BUN) <br>❑ [[Gram staining|Sputum gram stain]] <br>❑ [[Sputum culture]] <br>❑ [[Blood culture]] if necessary<br>❑ If suspecting [[atypical pneumonia]] obtain: <br> | ||
:❑ Urine [[legionella]] antigen<br> | :❑ Urine [[legionella]] antigen<br> | ||
:❑ [[Enzyme linked immunosorbent assay (ELISA)|Enyzme Immunoassay (EIA)]] <br> | :❑ [[Enzyme linked immunosorbent assay (ELISA)|Enyzme Immunoassay (EIA)]] <br> | ||
:❑ [[Immunofluorescence]] <br> | :❑ [[Immunofluorescence]] <br> | ||
:❑ [[Polymerase chain reaction]] (PCR) for atypical and viral including [[influenza]]<br> | :❑ [[Polymerase chain reaction]] (PCR) for atypical and viral including [[influenza]]<br></div>}} | ||
{{familytree | | | | | | | | | |!| | | | | | | | | | | | | | | | | | }} | {{familytree | | | | | | | | | |!| | | | | | | | | | | | | | | | | | }} | ||
{{familytree | | | | | | | | | D01 | | | | | | | | | | | | | | | | | D01=<div style="float: left; text-align: left; width: | {{familytree | | | | | | | | | D01 | | | | | | | | | | | | | | | | | D01=<div style="float: left; text-align: left; width: 20em; padding:1em;">❑ Order a chest X-ray if the patient presents with any of the following:<ref name="pmid21661712">{{cite journal| author=Watkins RR, Lemonovich TL| title=Diagnosis and management of community-acquired pneumonia in adults. | journal=Am Fam Physician | year= 2011 | volume= 83 | issue= 11 | pages= 1299-306 | pmid=21661712 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21661712}} </ref> | ||
* [[Fever]] (>37.8° C / 100° F) | * [[Fever]] (>37.8° C / 100° F) | ||
* [[Tachypnea]] (> 20 breaths/min) | * [[Tachypnea]] (> 20 breaths/min) | ||
* [[Tachycardia]] (> 100 bpm) | * [[Tachycardia]] (> 100 bpm) | ||
* Decreased [[breath sounds]] and [[crackles]] in the physical exam </div>}} | * Decreased [[breath sounds]] and [[crackles]] in the physical exam </div>}} | ||
{{familytree/end}} | {{familytree | | | | | | | | | |!| | | | | | | | | | | | | | | | | | }} | ||
{{familytree | | | | | | | | | E01 | | | | | | | | | | | | | | | | | E01=<div style="float: left; text-align: left; width: 20em; padding:1em;">Does the patient meets any of the following criteria for HCAP?</div>}} | |||
{{familytree/end}}</div> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 16:33, 8 December 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
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Overview
Diagnostic Algorithm
Shown below is an algorithm for the diagnostic approach of pneumonia.[1][2] Abbreviations: HCAP: Healthcare-associated Pneumonia
Physical Examination: ❑ Fever | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Order Labs: ❑ Complete blood count (CBC) ❑ Blood urea nitrogen (BUN) ❑ Sputum gram stain ❑ Sputum culture ❑ Blood culture if necessary ❑ If suspecting atypical pneumonia obtain:
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❑ Order a chest X-ray if the patient presents with any of the following:[3]
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Does the patient meets any of the following criteria for HCAP? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ "http://cid.oxfordjournals.org/content/44/Supplement_2/S27.full.pdf+html". Retrieved 13 March 2014. External link in
|title=(help) - ↑ "MMS: Error".
- ↑ Watkins RR, Lemonovich TL (2011). "Diagnosis and management of community-acquired pneumonia in adults". Am Fam Physician. 83 (11): 1299–306. PMID 21661712.