Adult Pneumonia Pathway - Diagnosis
- Symptoms of an acute lower respiratory tract illness i.e, cough and at least one other lower respiratory tract symptom, e.g. dyspnoea, sputum, or pleuritic chest pain.
- New focal chest signs on examination.
- Evidence of systemic illness: temperature above 38°C and/or sweating, fevers, shivers, aches, and pains.
- Differentiate pneumonia from acute bronchitis, for which antibiotics are usually not required (except in acute COPD).
- NB: Sputum sample and chest Xray are not routinely needed at initial assessment.
- Also see 'Alternative diagnoses'.
- Consider Legionella infection:
- Risk factors – history of recent gardening activities, including exposure to potting mix, or potentially contaminated and aerosolised water sources, such as humidifiers, air conditioners or hot-water systems.
- More common during the spring and summer months.
- Symptoms are less helpful than risk factors in assessing risk for legionella, but may include:
- dry coughing.
- high fever, chills.
- shortness of breath, chest pains.
- headaches, excessive sweating.
- nausea, vomiting.
- abdominal pain.
- diarrhoea, which is more common than with other forms of community-acquired pneumonia.
Last updated : Monday, January 15, 2018
Next review date : Tuesday, January 15,2019
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