Diagnosis of Pneumonia
If you go to your doctor with symptoms of pneumonia, he or she will ask about your medical history, travel history, and other exposures that might suggest what type of pneumonia you have. A thorough physical examination usually includes tapping on your chest and back (to identify the presence of fluid or trapped air in your lungs) and listening carefully to your chest and back with a stethoscope.
Your doctor may choose to order a variety of tests, such as:
Blood Tests —Complete blood count including the number and types of white blood cells may help determine whether you have a viral, bacterial, or fungal infection.
Blood Culture —This involves sending a blood sample to a laboratory where it can be processed to see if any organisms are growing. If there are organisms, they can often be identified, and tests can be run to determine what types of antibiotics can best eliminate them.
Pulse Oximetry —This test measures the amount of oxygen in your blood to get a sense of how ill you are.
Arterial Blood Gas —This blood test measures the concentration of certain substances in your blood, including oxygen, carbon dioxide, and pH. This test may be performed to determine whether you will be able to continue breathing on your own, or whether you may need treatment with additional oxygen or mechanical ventilation.
Sputum Culture —If you’re able to cough up a sample of sputum, it can be sent to a laboratory to examine it for the presence of specific organisms. If there are organisms in the sputum, they can often be identified, and a specific antibiotic can be ordered for you.
]]>Chest X-ray]]> —Chest x-ray may reveal signs of pneumonia. However, sometimes a patient will have clear-cut symptoms and signs of pneumonia on physical exam with a clear x-ray for the first couple of days. This is often the case if a patient is dehydrated.
]]>CT Scan]]> —This imaging procedure is reserved for those patients in whom lung cancer is suspected.
]]> Bronchoscopy ]]> —In this procedure, a narrow, lighted scope is passed through your mouth or nose, down your bronchial tubes, and into your lungs. Your healthcare provider can examine your entire respiratory tract for signs of pneumonia. Samples of fluid and biopsies of tissue can be taken through the bronchoscope. These samples can be processed and examined in a laboratory to try and identify organisms that might be causing your pneumonia.
]]>Thoracentesis]]> (Pleural Fluid Aspiration) —This invasive procedure is performed if pneumonia is complicated by fluid accumulation in the lung (pleural effusions). A needle can be passed through the chest, back, or between the ribs in order to withdraw excess fluid in the chest cavity. This fluid can be examined in a laboratory to identify organisms responsible for the pneumonia.
Placement of Thoracentesis Needle
American Lung Association website. Available at: http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=22542 . Accessed July 17, 2008.
Heyland D, Dodek P, MuscedereJ, Day A. A randomized trail of diagnostic techniques for ventilator-associated pneumonia. N Engl J Med. 2006;355:2619-2630.
Lutfiyya MN, Henley E, Change LF. Diagnosis and treatment of community-acquired pneumonia. Am Fam Physician. 2006;73:442-450
Mayer J. Laboratory diagnosis of nosocomial pneumonia. Semin Respir Infect. 2000;15:119-131
Murphy, CG, van de Pol, AC, Harper, MB, Bachur, RG. Clinical predictors of occult pneumonia in the febrile child. Acad Emerg Med. 2007; 14:243.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ . Accessed July 17, 2008.
Primary Care Medicine . 4th ed. Lippincott Williams and Wilkins; 2000.
Last reviewed July 2008 by ]]>Marcin Chwistek, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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