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==Diagnostic Algorithm==
==Diagnostic Algorithm==
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>
{{familytree/start}}
{{familytree | | | | | | | | | A01 | | | | | | | | | | | | | | | | | A01=<div style="float: left; text-align: left; width: 30em; padding:1em; width:13em"> '''Most common symptoms:'''<br>❑ [[Fever]] <br>❑ [[Cough]] with sputum <br>❑ [[Dyspnea]]<br>❑ [[Pleuritic]] chest pain</div> }}
{{familytree | | | | | | | | | |!| | | | | | | | | | | | | | | | | | }}
{{familytree | | | | | | | | | B01 | | | | | | | | | | | | | | | | | B01=<div style="float: left; text-align: left; width: 30em; padding:1em; width:13em">'''Physical Examination:''' <br>
❑ [[Fever]] and/or <br>
❑ [[Tachypnea]] and/or <br>
❑ Respiratory examination:
❑ [[Percussion|Dull percussion]] on affected side<br>
❑ [[Breath sounds|Bronchial breath sounds]]<br>
❑ [[Rales]] and/or <br>❑ [[Vocal fremitus|Increased vocal fremitus]] <br>
❑ [[Whispered pectoriloquy]]<br>
❑ [[Pleural friction rub]]</div>}}
{{familytree | | | | | | | | | |!| | | | | | | | | | | | | | | | | | }}
{{familytree | | | | | | | | | C01 |-|-|-|-|-|-|.| | | | | | | | | | C01=<div style="float: left; text-align: left; width: 30em; padding:1em; width:13em">'''Order Labs:'''<br> ❑ Order [[complete blood count]] (CBC) <br>❑ Check [[Blood urea nitrogen]] (BUN)  <br>❑  Perform [[Gram staining|sputum gram stain]] <br>❑ [[Sputum culture]] <br>❑ [[Blood culture]]<br>❑ If suspecting [[atypical pneumonia]] obtain: <br>
:❑ Urine [[legionella]] antigen<br>
:❑ [[Enzyme linked immunosorbent assay (ELISA)|Enyzme Immunoassay (EIA)]] <br>
:❑ [[Immunofluorescence]] <br>
:❑ [[Polymerase chain reaction]] (PCR) for atypical and viral including [[influenza]]<br>
:❑ [[Influenza]] testing during influenza season </div>}}
{{familytree | | | | | | | | | |!| | | | | | | |!| | | | | | | | | | }}
{{familytree | | | | | | | | | D01 | | | | | | |!| | | | | | | | | | D01=<div style="float: left; text-align: left; width: 30em; padding:1em; width:13em">❑ 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)
* [[Tachypnea]] (> 20 breaths/min)
* [[Tachycardia]] (> 100 bpm)
* Decreased [[breath sounds]] and [[crackles]] in the physical exam </div>}}
{{familytree/end}}


==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 16:13, 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]


 
 
 
 
 
 
 
 
Most common symptoms:
Fever
Cough with sputum
Dyspnea
Pleuritic chest pain
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Physical Examination:

Fever and/or
Tachypnea and/or
❑ Respiratory examination: ❑ Dull percussion on affected side
Bronchial breath sounds
Rales and/or
Increased vocal fremitus
Whispered pectoriloquy

Pleural friction rub
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Order Labs:
❑ Order complete blood count (CBC)
❑ Check Blood urea nitrogen (BUN)
❑ Perform sputum gram stain
Sputum culture
Blood culture
❑ If suspecting atypical pneumonia obtain:
❑ Urine legionella antigen
Enyzme Immunoassay (EIA)
Immunofluorescence
Polymerase chain reaction (PCR) for atypical and viral including influenza
Influenza testing during influenza season
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
❑ Order a chest X-ray if the patient presents with any of the following:[3]
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

References

  1. "http://cid.oxfordjournals.org/content/44/Supplement_2/S27.full.pdf+html". Retrieved 13 March 2014. External link in |title= (help)
  2. "MMS: Error".
  3. Watkins RR, Lemonovich TL (2011). "Diagnosis and management of community-acquired pneumonia in adults". Am Fam Physician. 83 (11): 1299–306. PMID 21661712.