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martes, 14 de marzo de 2017

Community-Acquired Pneumonia

emDocs
EMDOCS CASES - March 13, 2017 - Authors: Long B and Long D -  Edited by: Koyfman A
"Summary
  • Pneumonia possesses a wide range of presentations.
  • One study shows a prevalence of 2.6% for pneumonia in patients with URI symptoms, while other studies suggest this is closer to 7%.
  • No combination of history, exam, and testing can improve the diagnostic probability of pneumonia to over 50%.
  • Patients younger than 65 years with normal vital signs and normal lung exam may not require a CXR. Patients with URI symptoms, vital sign abnormalities, and abnormal lung findings should have imaging.
  • For imaging, US can be beneficial. Patients with high likelihood of pneumonia and negative CXR, such as those with immunosuppression, dehydration, and older age, may need additional imaging such as CT chest.
  • Clinical scores can assist in risk stratification and disposition, but they should only be used in association with clinical judgment and gestalt.
  • Patient social situation, substance abuse history, and PO tolerance should be taken into consideration."