Community-acquired pneumonia diagnostic criteria: Difference between revisions
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==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)== | ==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)== | ||
====Major Criteria==== | |||
===Minor Criteria=== | |||
* Invasive [[mechanical ventilation]] | |||
* [[Septic shock]] with the need for [[vasopressors]] | |||
====Minor Criteria==== | |||
* Respiratory rate >30 breaths/min | * Respiratory rate >30 breaths/min | ||
* PaO2/FiO2 ratio <250 | * PaO2/FiO2 ratio <250 | ||
| Line 17: | Line 23: | ||
* [[Hypothermia]] (core temperature, <36 degrees C) | * [[Hypothermia]] (core temperature, <36 degrees C) | ||
* [[Hypotension]] requiring aggressive fluid resuscitation | * [[Hypotension]] requiring aggressive fluid resuscitation | ||
==Clinical Prediction Rule for Predicting Pulmonary Infiltrates Based on Clinical Findings== | |||
A [[clinical prediction rule]] found the five following signs from the medical history and [[physical examination]] best predicted infiltrates on the chest [[radiography|radiograph]] of 1134 patients presenting to an emergency room:<ref name="pmid2221647">{{cite journal |author=Heckerling PS, Tape TG, Wigton RS, ''et al'' |title=Clinical prediction rule for pulmonary infiltrates |journal=Ann. Intern. Med. |volume=113|issue=9 |pages=664–70 |year=1990 |pmid=2221647 |doi=}}</ref> | |||
* Temperature > 100 degrees F (37.8 degrees C) | |||
* Pulse > 100 beats/min | |||
* [[Rales|Crackles]] | |||
* Decreased [[breath sound]]s | |||
* Absence of [[asthma]] | |||
{| class="wikitable" | |||
|+ Probability of an Infiltrate <BR> Based on the Number of Findings | |||
! Number of Findings | |||
! Primary Care | |||
! Emergency Room | |||
|- | |||
| 5 || 47% || 75% | |||
|- | |||
| 4 || 27 || 56 | |||
|- | |||
| 3 || 8 || 22 | |||
|- | |||
| 2 || 4 || 11 | |||
|- | |||
| 1 || 1 || 3 | |||
|- | |||
| 0 || 1|| 2 | |||
|} | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Needs overview]] | [[Category:Needs overview]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
| Line 60: | Line 64: | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:primary care]] | [[Category:primary care]] | ||
Revision as of 12:46, 18 February 2014
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Community-Acquired Pneumonia Microchapters |
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Differentiating Community-acquired pneumonia from other Diseases |
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Risk calculators and risk factors for Community-acquired pneumonia diagnostic criteria |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Infectious Diseases Society of America/American Thoracic Society Consensus Recommendation Criteria for Severe Community Acquired Pneumonia in Adults[1] (DO NOT EDIT)
Major Criteria
- Invasive mechanical ventilation
- Septic shock with the need for vasopressors
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
Clinical Prediction Rule for Predicting Pulmonary Infiltrates Based on Clinical Findings
A clinical prediction rule found the five following signs from the medical history and physical examination best predicted infiltrates on the chest radiograph of 1134 patients presenting to an emergency room:[2]
- Temperature > 100 degrees F (37.8 degrees C)
- Pulse > 100 beats/min
- Crackles
- Decreased breath sounds
- Absence of asthma
| Number of Findings | Primary Care | Emergency Room |
|---|---|---|
| 5 | 47% | 75% |
| 4 | 27 | 56 |
| 3 | 8 | 22 |
| 2 | 4 | 11 |
| 1 | 1 | 3 |
| 0 | 1 | 2 |
References
- ↑ 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) - ↑ Heckerling PS, Tape TG, Wigton RS; et al. (1990). "Clinical prediction rule for pulmonary infiltrates". Ann. Intern. Med. 113 (9): 664–70. PMID 2221647.