Pneumonia diagnostic algorithm: Difference between revisions
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❑ [[Tachypnea]] <br> | ❑ [[Tachypnea]] <br> | ||
❑ [[Tachycardia]] <br> | ❑ [[Tachycardia]] <br> | ||
❑ [[Percussion| | ❑ [[Percussion|Dullness to percussion]] on affected side<br> | ||
{{col-break|width=50%}} | {{col-break|width=50%}} | ||
❑ [[Breath sounds|Bronchial breath sounds]]<br> | ❑ [[Breath sounds|Bronchial breath sounds]]<br> | ||
❑ [[Rales]] | ❑ [[Rales]] <br> | ||
❑ [[Vocal fremitus|Increased vocal fremitus]] <br> | ❑ [[Vocal fremitus|Increased vocal fremitus]] <br> | ||
❑ [[Pleural friction rub]] | ❑ [[Pleural friction rub]] | ||
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{{familytree | | | | | | | | |!| | | | | | | | | | | }} | {{familytree | | | | | | | | |!| | | | | | | | | | | }} | ||
{{familytree | | | | | | | | C01 | | | | | | | | | | C01=<div style="float: left; text-align: left; width: 28em; padding:0.5em;">'''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> | {{familytree | | | | | | | | C01 | | | | | | | | | | C01=<div style="float: left; text-align: left; width: 28em; padding:0.5em;">'''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, rapid influenza test<br> | ||
:❑ [[Enzyme linked immunosorbent assay (ELISA)|Enyzme Immunoassay | :❑ [[Enzyme linked immunosorbent assay (ELISA)|Enyzme Immunoassay]] <br> | ||
:❑ [[Immunofluorescence]] <br> | :❑ [[Immunofluorescence]] <br> | ||
:❑ [[Polymerase chain reaction]] (PCR) for atypical and viral including [[influenza]]<br></div>}} | :❑ [[Polymerase chain reaction]] (PCR) for atypical and viral including [[influenza]]<br></div>}} | ||
Revision as of 18:42, 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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Pneumonia Microchapters |
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Diagnosis |
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Treatment |
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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; CAP: Community-acquired pneumonia
Physical Examination Findings:
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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?[4]
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YES | NO The patient has CAP | ||||||||||||||||||||||||||||||||||||||
Does the infection occurred ≥48 hours after admission and it was not present at admission? | Does the patient meets any of the Severity Criteria? Minor Criteria
Major criteria
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YES | NO The patient has HCAP | YES Admit the patient and administer inpatient antibiotic regimen | NO Administer outpatient antibiotic regimen | ||||||||||||||||||||||||||||||||||||
References
- ↑ "http://cid.oxfordjournals.org/content/44/Supplement_2/S27.full.pdf+html". Retrieved 13 March 2014. External link in
|title=(help) - ↑ Solomon, Caren G.; Wunderink, Richard G.; Waterer, Grant W. (2014). "Community-Acquired Pneumonia". New England Journal of Medicine. 370 (6): 543–551. doi:10.1056/NEJMcp1214869. ISSN 0028-4793.
- ↑ Watkins RR, Lemonovich TL (2011). "Diagnosis and management of community-acquired pneumonia in adults". Am Fam Physician. 83 (11): 1299–306. PMID 21661712.
- ↑ 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)