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Physical Findings of Pneumonia

In this article, we will discuss the Physical Findings of Pneumonia. So, let’s get started.

Physical Findings

  • Fever or hypothermia, tachycardia, and arterial gas desaturation
  • An increased respiratory rate and use of accessory muscles of respiration
  • Palpation reveals increased or decreased vocal fremitus (pleural effusion)
  • Percussion reveals dull percussion note on the area involved
  • Auscultation reveals crackles, bronchial breath sounds. A pleural rub may be heard over the area involved.
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Differential Diagnosis of Pneumonia

In this article, we will discuss about the Differential Diagnosis of Pneumonia. So, let’s get started.

Differential Diagnosis

Differential diagnosis to be considered while diagnosing pneumonia includes

Acute bronchitis

Chronic bronchitis with acute exacerbation

Heart failure

Pulmonary embolism

Hypersensitivity pneumonia

Radiation pneumonitis

Acute exacerbation of bronchiectasis, pulmonary fibrosis

Pulmonary vasculitis

Aspiration pneumonitis

Influenza

Pertusis

Cocaine-induced lung injury

Refer below image for more differential diagnosis

Diagnosis of Pneumonia

In this article, we will discuss about the Diagnosis of Pneumonia. So, let’s get started.

Diagnosis

Chest x-ray is helpful in confirming the presence and location of pulmonary infiltrates. Most pathogens produce focal lesions except for P.carinii which produces diffuse lesions. X-ray (chest) helps in determining the extent of lung involvement, pleural involvement, adjoining lymphadenopathy (hilar lymphadenopathy), and pulmonary cavitation. Usually chest x-ray shows reticular pattern in mycoplasma infection, and homogenous localised opacity and air bronchogram in S.pneumoniae infection.

Sputum examination helps to determine the pathogen responsible for causing the infection, it still remains the mainstay of the diagnosis of pneumonia. but its specificity and sensitivity has been decreased because the sample easily gets contaminated during expectoration with bacteria that colonise the upper respiratory tract.

Blood test revealing increased TLC, DLC, and ESR suggests an evidence of infection.

Other tests includes serological tests such as indirect immunoflurescence test, PCR, indirect fluorescent test, and microimmunofluorescence test, examining pleural aspiration (if empyema is the clinical consideration), and pleural fluid culture.

ECG shows myocarditis in C.burnetti infection.

Invasive diagnostic procedures includes transtracheal aspiration, percutaneous transthoracic lung puncture and aspiration, open lung biopsy, and Fibreoptic bronchoscopy.

Biomarkers of inflammation such as CRP, and procalcitonin increases during acute phase of infection.

Arterial blood gas or oxygen saturation evaluation also helps in the diagnosis of pneumonia.

Pneumonia

In this article, we will discuss about the Definition and Types of Pneumonia. So, let’s get started.

Pneumonia is defined as an acute inflammation of the lung parenchyma along with features of consolidation and exudation on clinical and radiological examination. It is one of the leading cause of death and morbidity in the developing as well as in developed countries. It is also one of the most common cause of nosocomial infection in adults and children.

Types

Community-acquired Pneumonia which refers to pneumonia occuring in healthy adults in a community. It usually spread by droplets inhalation (airborne) and ciggratte smoking, alcoholism, and immunosuppression (immunosuppressive individuals such as HIV affected individuals, diabetics etc or individuals on immunosuppressive drugs) acts as predisposing factors.

Hospital-acquired and Ventilator-associated Pneumonia or Nosocomial Pneumonia refers to infection that is developed more than 48 hours after admission to the hospital (i.e Hospital-acquired) or more than 48 hours after endotracheal intubation in mechanically ventilated patients (i.e Ventilator-associated)

Read further articles on Pneumonia given below

Symptoms and Physical findings of Pneumonia

Causative Pathogens responsible for community-acquired Pneumonia

Symptoms and Physical findings of Pneumonia

In this article, we will discuss about various Symptoms and Physical findings of Pneumonia. So, let’s get started.

Symptoms and Physical findings

Fever

Sweats

Chills

Productive cough (with mucoid or purulent sputum), non-productive cough or dry cough

Hemoptysis

Rarely, pleuritic chest pain

Severely ill patients may show signs of septic shock and evidence of organ failure

Other symptoms include

Headache

Myalgia

Nausea

Vomiting

Fatigue

Sore throat

Diarrhea

Physical findings include tachycardia, arterial gas desaturation, tachypnea, use of accessory muscle during respiration, increased or decreased vocal fremitus on palpation, percussion reveals dull note on the involved area, and auscultation reveals crackles, bronchial breath sound and pleural rub over the area involved.

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