Last reviewed: 7 Feb 2021
Last updated: 07 May 2020
Summary
Definition
History and exam
Other diagnostic factors
- chest pain
- asymmetric expansion of the chest
- diminished resonance
- egophony
- whisper pectoriloquy
- crackles or rhonchi
- tachycardia
- malaise/anorexia
Risk factors
- poor infection control/hand hygiene
- head of bed at <30° angle
- intubation and mechanical ventilation; endotracheal cuff pressure <20 cm H2O
- H2 antagonist and antacid use
- poor oral hygiene
- no interruption in sedation
- reintubation
Diagnostic investigations
1st investigations to order
- chest x-ray
- WBC count with differential
- pulse oximetry
- culture of lower respiratory tract sample
Investigations to consider
- ABG
- diagnostic thoracentesis
- CT chest
- CRP
- procalcitonin
Treatment algorithm
INITIAL
ACUTE
Contributors
Authors

Associate Professor of Medicine
Division of Infectious Diseases
Department of Medicine
School of Medicine
University of Louisville
Louisville
KY
Disclosures
FWA declares that he has no competing interests.
Peer reviewers
Associate Professor (Clinical)
Department of Medicine
University of Utah
Director
Pulmonary and Critical Care Research
IHC Urban South
Utah Valley Pulmonary Clinic
UT
Disclosures
KS declares that he has no competing interests.
Director of Research
Associate Professor
Department of Anesthesiology and Perioperative Medicine
Neuroscience and Anesthesia Intensive Care Unit
University of Louisville
Louisville
KY
Disclosures
OA declares that he has no competing interests.
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