最近审阅: 八月 2020
最近更新: 三月  2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 咳嗽伴痰增多
  • 发热或寒战
  • 呼吸困难
  • 胸膜痛
  • 听诊异常

其他诊断因素

  • 叩诊浊音
  • 肌痛
  • 关节痛
  • 意识模糊

危险因素

  • 年龄>65 岁
  • 居住在医疗保健机构
  • 慢性阻塞性肺疾病 (COPD)
  • 暴露于香烟烟雾
  • 酗酒
  • 口腔卫生不佳
  • 使用胃酸抑制类药物、吸入用皮质类固醇、抗精神病药物、降糖药物
  • 与儿童接触
  • HIV 感染
  • 糖尿病
  • 慢性肾病
  • 慢性肝病
  • 阿片类药物的应用

诊断性检查

首要检查

  • 胸部 X 线检查
  • 全血细胞计数(FBC)
  • 血清电解质、尿素
  • 肝功能检查
  • 血糖
  • 动脉血气/血氧测定法
  • 血液培养
  • 痰培养
更多 首要检查

需考虑的检查

  • 肺部超声
  • 胸部 CT
  • 针对军团菌和肺炎球菌的尿抗原检测
  • 血清 C 反应蛋白
  • 血清原降钙素
  • 胸腔穿刺术和胸水培养
  • 支气管镜检查
  • 呼吸道病毒检测
  • 分子微生物技术
更多 需考虑的检查

治疗流程

撰稿人

Post-doctoral Research

Pneumology Department

Hospital Clinic of Barcelona

CIBERES

IDIBAPS

Barcelona

Spain

利益声明

CC is an author of a number of references cited in this topic.

Professor of Medicine

Director

Pulmonary Intensive Care Unit

Respiratory Institute

Hospital Clinic of Barcelona

Barcelona

Spain

利益声明

AT is an author of a number of references cited in this topic.

Dr Catia Cilloniz and Professor Antoni Torres would like to gratefully acknowledge Dr M. Nawal Lutfiyya, Dr Linda Chang, and Dr Robert Bales, previous contributors to this topic.

同行评议者展开全部内容

Assistant Professor

Division of Pulmonary and Critical Care Medicine

University of Utah

Salt Lake City

UT

利益声明

BJ declares that she has no competing interests.

Associate Professor

Departments of Emergency Medicine and Medicine

Icahn School of Medicine at Mount Sinai

New York

NY

利益声明

DN declares that she has no competing interests.

Professor of Medicine

Royal Perth Hospital

Perth

Australia

利益声明

GW declares that he has no competing interests.

Professor of Respiratory Infection/Honorary Consultant

University College London

London

UK

利益声明

JB was a member of the NICE pneumonia guidelines committee.

Professor (clinical) of Medicine

Section Chief Pulmonary Critical Care Medicine

University of Utah

Intermountain Medical Center

Murray

UT

利益声明

ND declares that he has no competing interests.

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