Summary
Definition
History and exam
Key diagnostic factors
- persistent cough
- dry cough
- prolonged symptoms
- fever
- adventitious sounds on physical exam
- exposure to a person with respiratory tract infection
Other diagnostic factors
- throat involvement
- rash
- headache
- bullous myringitis
- hepatitis
Risk factors
- close community settings
- recent exposure
- cigarette smoking
- age <30 years
- immunosuppression
- asplenia
Diagnostic tests
1st tests to order
- WBC count
- hemoglobin
- LFTs
- pulse oximetry
- BUN and electrolytes
- C-reactive protein
- chest x-ray
Tests to consider
- nucleic acid amplification test (NAAT)
- serology
- culture±/Gram stain
Emerging tests
- antigen test
Treatment algorithm
with pneumonia
Contributors
Authors
Ran Nir-Paz, MD

Professor in Medicine and Clinical Microbiology
Department of Clinical Microbiology and Infectious Diseases
Hadassah-Hebrew University Medical Center
Jerusalem
Israel
Disclosures
RNP declares that he has no competing interests. RNP is an author of several references cited in this topic.
Takeshi Saraya, MD, PhD
Associate Professor
Department of Respiratory Medicine
Kyorin University School of Medicine
Tokyo
Japan
Disclosures
TS declares that he has no competing interests.
Peer reviewers
Enno Jacobs, MD
Director
Institute for Medical Microbiology and Hygiene
Dresden
Germany
Disclosures
EJ declares that he has no competing interests.
Laura J. Christie, MD
Research Scientist
Pediatric Infectious Disease
California Department of Public Health
Viral and Rickettsial Disease Laboratory
Richmond
CA
Disclosures
LC declares that she has no competing interests.
References
Key articles
British Thoracic Society. BTS guidelines for the management of community acquired pneumonia in adults: update 2009. Jan 2015 [internet publication].Full text
Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-67.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Coronavirus disease 2019 (COVID-19)
- Typical bacterial pneumonia
- Viral pneumonia
More DifferentialsGuidelines
- Diagnosis and treatment of adults with community-acquired pneumonia
- Pneumonia (community-acquired): antimicrobial prescribing
More GuidelinesPatient information
Pneumonia
Pneumonia: do I need a vaccine?
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CURB-65 pneumonia severity score
Community-acquired pneumonia severity index (PSI) for adults
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