General Medicine  |  Adult Pneumonia Pathway - Diagnosis

General Medicine

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 : Friday, May 18, 2018
Next review date : Saturday, May 18,2019

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