Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- positive past medical history
- fever
- productive cough
- cavernous (amphoric) breath sounds
Outros fatores diagnósticos
- cardiac murmur
- pleuritic chest pain
- constitutional symptoms
- cachexia
- pallor
- gingival disease
- halitosis
- absence of gag reflex
- dyspnea
- hemoptysis
- rigors
- weakness
- arthralgia
- hemorrhagic lesions
- inspiratory crackles
- bronchial breathing
- decreased breath sounds
- unilateral fixed rhonchus
Fatores de risco
- predisposition to aspiration of gastric contents
- poor dental hygiene and tooth extraction
- bronchial obstruction
- immunosuppression
- chronic illness
- extrapulmonary sepsis
- pneumonia
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- CBC
- chest x-ray
- sputum Gram stain
- sputum culture
- blood culture
- empyema fluid culture
Investigações a serem consideradas
- CT chest
- bronchoscopy
- quantitative cultures of protected specimen brushings
- quantitative cultures of protected bronchoalveolar lavage samples
- percutaneous needle aspiration and culture
- sputum cytology
- lung ultrasound
- echocardiogram
- rapid enzyme-linked immunosorbent assay (ELISA) for D-dimer
- multidetector CT thorax
- ventilation-perfusion scan
Algoritmo de tratamento
low probability of gram-negative or multidrug resistant organism
high probability of gram-negative or multi-drug resistant organism
low probability of gram-negative or multidrug resistant organism
high probability of gram-negative or multidrug resistant organism: with or without penicillin/cephalosporin allergy
Colaboradores
Autores
Ioannis P. Kioumis, MD, PhD
![Ioannis P. Kioumis](/api/image/927/en-us/normal/927-auth-1_default.jpg)
Professor of Respiratory Medicine and Infectious Diseases
Aristotle University of Thessaloniki
Respiratory Failure Clinic
General Hospital G. Papanikolaou
Thessaloniki
Greece
Declarações
IPK declares that he has no competing interests.
Georgia G. Pitsiou, MD, PhD
![Georgia G. Pitsiou](/api/image/927/en-us/normal/927-auth-2_default.jpg)
Professor of Respiratory Medicine
Aristotle University of Thessaloniki
Respiratory Failure Clinic
General Hospital G. Papanikolaou
Thessaloniki
Greece
Declarações
GGP declares that she has no competing interests.
Revisores
William G. Cheadle, MD
Professor of Surgery
University of Louisville
Associate Chief of Staff for Research and Development
VAMC Louisville
Louisville
KY
Declarações
WGC declares that he has no competing interests.
Nicholas Maskell, MD
Senior Lecturer and Consultant Physician
North Bristol Lung Centre
Southmead Hospital
Bristol
UK
Declarações
NM declares that he has no competing interests.
Najib Rahman, BM, BCh, MA (Oxon), MRCP (UK)
MRC Training Fellow and Specialist Registrar, Respiratory Medicine
Oxford Centre for Respiratory Medicine
Churchill Hospital
Oxford
UK
Declarações
NR declares that he has no competing interests.
Philip W. Ind, BA (Cantab), MB BChir, MA (Cantab), FRCP
Consultant Physician
Honorary Senior Lecturer
Imperial College Healthcare Trust
Hammersmith Hospital
London
UK
Declarações
PWI declares that he has no competing interests.
Diagnósticos diferenciais
- Neoplasm (primary or metastatic lung cancer, lymphoma)
- Tuberculosis
- Necrotizing pneumonia
Mais Diagnósticos diferenciaisDiretrizes
- Practice guideline for specifications and performance of image-guided percutaneous drainage/aspiration of abscesses and fluid collections (PDAFC)
- Appropriateness criteria: radiologic management of infected fluid collections
Mais DiretrizesConectar-se ou assinar para acessar todo o BMJ Best Practice
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