Community-acquired pneumonia diagnostic criteria
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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]
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.