Pneumonia Physical Exam

Respiratory infections are some of the most common diseases that affect children and adults alike. Not all respiratory infections are equally serious. Treating the common cold or flu is easily managed compared to more serious infections like pneumonia. At our Beverly Hills medical office, our staff of Los Angeles specialists perform a thorough pneumonia physical exam to diagnose this disease accurately and start treatment promptly.

What is pneumonia?

Pneumonia is an infection of the lungs caused by microbes including bacteria, viruses, and fungi. This infection may cause buildup of fluid or pus in the small air sacs (called alveoli) inside your lungs. Pneumonia is contagious since most microbes can be transmitted via air droplets (while sneezing or coughing) so it can spread from one person to another. Pneumonia is classified based on causative agent (bacterial, viral, fungal) or based on setting (hospital-acquired, community-acquired, ventilator-associated).

Risk factors for developing pneumonia include:

  • Ages below 2 years or above 65 years
  • Smoking
  • Weak immunity due to medication use or chronic disease
  • Preexisting conditions like diabetes or asthma
  • Recent respiratory infection (cold or flu) that wasn’t treated properly
  • Recent hospitalization especially with ventilator use
  • Exposure to fumes or chemical irritants

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Signs and symptoms

Signs of pneumonia include:

  • Fever
  • Sweating
  • Productive, phlegmy cough
  • Chest pain
  • Shortness of breath and difficulty breathing
  • Fatigue
  • Nausea or vomiting

Pneumonia signs are not always the same, manifestation of symptoms depends on many factors like age and medical history. This infection, if not diagnosed and treated properly, can result in serious complications so if you’re experiencing any of the symptoms above, please visit our medical office as soon as possible to get a pneumonia physical exam.

Physical examination

Before your physician starts the physical exam, he or she will ask you some questions about your complaints. Be prepared to provide detailed information regarding your symptoms (cough, fever, fatigue) as well as your medical history (any preexisting conditions like asthma or diabetes) and lifestyle factors (smoking, recent travels, animal contact).
During the first part of your pneumonia physical exam, your physician will inspect your overall demeanor to identify signs of fatigue or dehydration. Your temperature, heart rate, and breathing will be also be checked. Afterwards, he or she will feel your lymph nodes to detect if there’s any enlargement (called lymphadenopathy) which is a sign of infection. Your physician will also lightly tap on your chest to check dullness over your lungs, this is called percussion dullness and can determine if there’s fluid inside your lungs. The final part of your physical exam is auscultation. This is when your physician will use a stethoscope to listen to your lung sounds. Pneumonia lung sounds are very different from normal healthy lung sounds, they are heard as fine crackling sounds (called rales) which reflect fluid buildup in the lungs.

Imaging

After your pneumonia physical exam is over, your physician will request some tests to confirm the diagnosis. The first line imaging method used to diagnose pneumonia is x-ray. But what does pneumonia look like on an x-ray? It appears as an opaque grayish region in your lung called consolidation. Depending on the results of your x-ray, your physician may request further imaging tests like a CT scan. If these tests are inconclusive, you might undergo a bronchoscopy which involves examining the inside of your lungs with a small camera on a flexible tube.

Lab tests

In addition to x-rays, laboratory tests are very helpful in identifying markers of infection. You can easily provide a blood sample at our office to be analyzed. Blood tests used in diagnosing pneumonia include:

  • Complete blood count (CBC) – used to check if there’s an increase of white blood cells which is a sign of active infection
  • Basic metabolic panel (BMP) – used to evaluate levels of minerals like sodium, potassium, and chloride
  • Blood gas analysis – used to assess lung function by measuring blood pH, oxygen, and carbon dioxide levels

Another special test that may be requested is sputum culture where a sample of the mucus you cough up is analyzed under the microscope to identify the exact microbe causing your infection. Once that microbe is identified, appropriate treatment can begin.

Treatment

Once diagnosed, pneumonia is treated with antimicrobials that target the causative agent found in your sputum. Antibacterials, antifungals, and antivirals are all options used to treat pneumonia. If you are dehydrated or your infection is severe, your medications can be directly administered intravenously using IV fluid therapy.

Several vaccines also exist to prevent pneumonia in case you are at risk (e.g. you are working in an environment with others suspected of pneumonia).

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