Bacterial pneumonia history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz

Overview

Detailed information pertaining to a patient's history may greatly assist in determining the underlying cause of pneumonia. It is also important to inquire about risk factors and comorbidities. Many patients present with common symptoms that often include fever, cough and a pleuritic chest pain.

History

It is important for health care providers to assess a patient's risk factors, including comorbidities and any conditions that may provide further information regarding the underlying cause of pneumonia. Affected individuals should be asked about:

• Duration of symptoms
• Presence of cough
  • Dry
  • Productive (Inquire about the amount and colour)
    • Productive cough may be indicative of:
      • Currant Jelly sputum: Klebsiella
      • Rust coloured sputum: Streptococcus pneumoniae
      • Green sputum: Hemophilus, Pseudomonas
      • Foul smelling/ bad-tasting sputum: Anaerobes
  • Hemoptysis
• Details pertaining to fever
  • Temperature
  • Duration
  • Pattern
  • Presence or absence of any chills
• Associated chest pain

It may also be helpful to inquire about certain exposures:

• Exposure to air-conditioning or water coolers and tanks (may indicate a Legionella pneumonia infection)
• Time spent in crowded locations such as homeless shelters, jails and prisons (may indicate a Streptococcus pneumonia, Mycobacteria, Mycoplasma, or Chlamydia infection)
• Animal Exposure (eg, Chlamydia psittaci is found in individuals with exposure to birds)
• Recent sick contacts

Symptoms

Common Symptoms

• Fever
• Chills
• Productive cough
• Dyspnea
• Chest pain (pleuritic)
• Weight loss

Elderly patients may experience:

• Weakness
• Lethargy
• Altered mental status
• Dyspepsia
• Absence of fever

Uncommon Symptoms

• Fatigue
• Headache
• Myalgia
• Arthralgia
• Diarrhea and hyponatremia (indicative of Legionella)
• Anemia and jaundice (hemolytic anemia) (indicative of Mycoplasma)