小结
定义
病史和体格检查
关键诊断因素
- 咳嗽伴痰增多
- 呼吸困难
- 发热
- 存在的危险因素
其他诊断因素
- 胸痛
- 胸腔不对称扩张
- 共振减少
- 听诊异常
- 心动过速
- 不适感/厌食
危险因素
- 感染控制/手部卫生不佳
- 插管和机械通气
- 多重耐药菌
- 误吸
- 抑酸药物
- 意识障碍
- 胸部或上腹部手术
诊断性检查
首要检查
- 氧饱和度
- 胸部 X 线检查
- 全血细胞计数
- 血气
- C 反应蛋白
- 肝肾功能检查
- 痰、鼻咽拭子或气管抽吸物培养
需考虑的检查
- 胸部 CT 扫描
- 胸腔超声
- 胸腔穿刺术和胸水培养
- 尿抗原检测
- PCR 和/或血清学检查，包括针对 SARS-CoV-2 的检查
- 血清原降钙素
治疗流程
重度症状/体征或耐药风险较高
轻中度症状/体征，并且没有较高的耐药风险
撰稿人
专家顾问
Jonathan Bennett, MD
Honorary Professor of Respiratory Sciences
University of Leicester
Respiratory Consultant
Glenfield Hospital
Leicester
UK
简介
JB is deputy medical director, RCP Invited Service Reviews, and speaker at national society meetings including (eg., British Thoracic Society, Primary Care Respiratory Society, and Society for Cardiothoracic Surgery.
利益声明
JB declares that he has no competing interests.
Claire Vella, MD, MRCP
Consultant Respiratory Physician
Glenfield Hospital
University Hospitals of Leicester NHS Trust
Leicester
UK
利益声明
CV declares that she has no competing interests.
Acknowledgements
BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:
Forest W. Arnold, DO MSc, FIDSA
Associate Professor of Medicine
Division of Infectious Diseases
Department of Medicine
School of Medicine
University of Louisville
Louisville
KY
利益声明
FWA declares that he has no competing interests.
同行评议者
Jeremy Brown, MBBS, MRCP, PhD
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.
编辑
Helena Delgado-Cohen
Section Editor, BMJ Best Practice
利益声明
HDC declares that she has no competing interests.
Rachel Wheeler
Lead Section Editor, BMJ Best Practice
利益声明
RW declares that she has no competing interests.
Julie Costello
Comorbidities Editor, BMJ Best Practice
利益声明
JC declares that she has no competing interests.
Adam Mitchell
Drug Editor, BMJ Best Practice
利益声明
AM declares that he has no competing interests.
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