Pneumonia
print Print
 
 
 
 
 
 
 
 
 
 
Text Label
Text minus
Text plus
How do doctors diagnose pneumonia?

Your doctor will ask about symptoms and may need to do some tests on your chest.

To find out if you have pneumonia, your doctor will look for:

  • A cough that doesn't go away after a few days
  • Pain in your chest that gets worse when you breathe in or out.
You may also have a high temperature (a fever) and not recover completely from a cough or cold.

You should be especially aware of the dangers of pneumonia if you or someone in your family:

  • Is more than 65 years old
  • Is less than 2 years old
  • Is a heavy smoker (smoking damages your lungs and this damage makes it more likely that you will get an infection)
  • Is a heavy drinker
  • Already has a lung disease, such as
     
     
     
     
     
    asthma
    Asthma is a long-term disease of the lungs. It makes you wheeze, cough and feel short of breath. Asthma attacks are caused by iflammation and narrowing of the airways, which makes it hard for air to pass in and out of the lungs.
     
     
     
     
     
    asthma or
     
     
     
     
     
    emphysema
    Emphysema is a long-term disease of the lungs. The walls of the air sacs (alveoli) in the lungs become thin and less elastic. This makes it harder for oxygen to get in your blood and carbon dioxide to get out of your body. It makes you cough and feel short of breath. Smoking is the most common cause of emphysema.
     
     
     
     
     
    emphysema
  • Has already had another illness, such as the
     
     
     
     
     
    flu
    The flu is a bad infection that gives you a headache, sore throat, aching joints and a fever. Flu is caused by infection with a virus called influenza.
     
     
     
     
     
    flu, which could have weakened their
     
     
     
     
     
    immune system
    The immune system is made up of the parts of the body that are devoted to fighting infection. The body is constantly being threatened by infections from things like bacteria, viruses and parasites. The immune system fights these infections in different ways. At the microscopic level, the immune system uses antibodies and white blood cells, which travel in the blood and target infectious agents, such as bacteria. These microscopic parts of the immune system either kill the infectious agent directly, or take it to other parts of the body, like the spleen, where it can be dealt with. The lymph nodes are another important part of the immune system. Within them, white blood cells filter through the foreign material that has entered the blood, to see if there are any infections. When you have a swollen gland during a cold, this is actually a lymph node that is reacting to the infection. Unfortunately, it is possible for the immune system to become confused and to use its destructive powers to target healthy parts of the body. Diseases that result from this type of situation are called autoimmune diseases.
     
     
     
     
     
    immune system and may make it harder for their body to fight off an infection
  • Has a long-term (chronic) disease, such as
     
     
     
     
     
    diabetes
    Diabetes is a condition that causes too much sugar to circulate in your blood. It happens when your body stops making a hormone called insulin (type 1 diabetes) or when insulin stops working (type 2 diabetes).
     
     
     
     
     
    diabetes,
     
     
     
     
     
    heart disease
    You get heart disease when your heart isn't able to pump blood as well as it should. This can happen for a variety of reasons.
     
     
     
     
     
    heart disease or
     
     
     
     
     
    sickle cell disease
    Sickle cell disease is a blood disorder that runs in families. Under certain conditions, the red blood cells of people with this disease change shape to look like a sickle. This causes a lot of pain and a range of other symptoms, including infections in the lungs.
     
     
     
     
     
    sickle cell disease
  • Has a disease such as
     
     
     
     
     
    AIDS
    AIDS stands for acquired immunodeficiency syndrome. People who are infected with the human immunodeficiency virus (HIV) get AIDS when the virus has destroyed most of their immune system. When people have AIDS, their body isn't able to fight infections. So even common infections, such as colds, can cause serious problems.
     
     
     
     
     
    AIDS or
     
     
     
     
     
    leukemia
    Leukemia is a type of cancer that affects the body's production of white blood cells. White blood cells are important for fighting infections. So, if you have leukemia you are more likely to catch an infectious disease.
     
     
     
     
     
    leukemia
  • Takes medicine for an illness like AIDS or cancer (some medicines, such as those given for
     
     
     
     
     
    chemotherapy
    Chemotherapy is the use of chemicals or drugs to treat or prevent disease, usually cancer.
     
     
     
     
     
    chemotherapy, can make it harder for your body to fight off an infection)
  • Has had an organ transplant.
Usually your doctor will be able to tell if you have pneumonia after:

  • Asking you about your symptoms. Your doctor will want to know if you have a
     
     
     
     
     
    high temperature
    A high temperature is a general sign that there is an infection or inflammation in your body. Temperatures vary, but anything over about 100 degrees Fahrenheit is considered high.
     
     
     
     
     
    high temperature (or fever), if you're short of breath, what kind of cough you have and if your chest hurts
  • Doing a physical examination. Your doctor will look at your chest to see if the shape of one side is different from the shape of the other. Your doctor will also tap your chest to see if areas of your lungs are blocked with mucus. And your doctor will listen to your lungs through a
     
     
     
     
     
    stethoscope
    A stethoscope is a tool doctors use to listen to people's bodies. One part of the stethoscope is a disc (called the bell), which doctors put over a part of someone's body (like their heart or a vein). The bell is connected to ear pieces, which the doctors put in their ears so they can listen to sounds that come from that part of the person's body.
     
     
     
     
     
    stethoscope. If your doctor hears bubbles or crackling noises, this suggests that your lungs are
     
     
     
     
     
    inflammation
    If your skin or some other part of your body becomes red, swollen, hot or sore, we say it is inflamed. It means that your body is trying to protect you from germs, from something in your body tissues that can hurt you (like a thorn or sliver), or from things that cause allergies (allergens). Inflammation is part of the way the body heals an infection or injury.
     
     
     
     
     
    inflamed or blocked.
     
     
     
     
     
    Source:
    Metlay JP, Kapoor WN, Fine MJ.
    Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination.
    Journal of the American Medical Association. 1997; 278: 1440-1445.
     
     
     
     
     
    1
Sometimes if your symptoms are bad, your doctor may also:

  • Get a chest X-ray. An
     
     
     
     
     
    X-ray
    X-rays are pictures taken of the inside of your body. They are done by passing very small amounts of radiation through your body and onto film. X-rays can also be used as a treatment, such as in radiation therapy for cancer.
     
     
     
     
     
    X-ray will usually show if there's an infection and how far it's spread
  • Order lab tests. Your blood and phlegm may have germs in them that will show up in the laboratory. A blood test can also measure how many
     
     
     
     
     
    white blood cells
    White blood cells are the cells in your blood that help your body fight infections. The other cells in your blood, red blood cells, carry oxygen around your body.
     
     
     
     
     
    white blood cells are in your blood. These cells are part of your
     
     
     
     
     
    immune system
    The immune system is made up of the parts of the body that are devoted to fighting infection. The body is constantly being threatened by infections from things like bacteria, viruses and parasites. The immune system fights these infections in different ways. At the microscopic level, the immune system uses antibodies and white blood cells, which travel in the blood and target infectious agents, such as bacteria. These microscopic parts of the immune system either kill the infectious agent directly, or take it to other parts of the body, like the spleen, where it can be dealt with. The lymph nodes are another important part of the immune system. Within them, white blood cells filter through the foreign material that has entered the blood, to see if there are any infections. When you have a swollen gland during a cold, this is actually a lymph node that is reacting to the infection. Unfortunately, it is possible for the immune system to become confused and to use its destructive powers to target healthy parts of the body. Diseases that result from this type of situation are called autoimmune diseases.
     
     
     
     
     
    immune system. If you have more of these cells than is normal, it may mean your body is fighting an infection.
If you are young and you don't have any obvious health problem to explain why you have pneumonia, your doctor may suggest that you have an
 
 
 
 
 
HIV
HIV stands for human immunodeficiency virus. It's the virus that causes AIDS. It makes you sick by damaging cells called CD4 cells. Your body needs these cells to fight infections. You can get HIV by sharing needles for injecting drugs ,or by having sex without a condom with someone who already has the virus.
 
 
 
 
 
HIV test. Being infected with HIV increases your risk of getting pneumonia.
 
 
 
 
 
Source:
Mandell LA, Marrie TJ, Grossman RF, et al.
Canadian guidelines for the initial management of community-acquired pneumonia: an evidence-based update by the Canadian Infectious Diseases Society and the Canadian Thoracic Society.
Clinical Infectious Diseases. 2000; 31: 383-421.
 
 
 
 
 
2
 
 
 
 
 
Source:
Bartlett JG, Dowell SF, Mandell LA, et al.
Practice guidelines for the management of community-acquired pneumonia in adults.
Clinical Infectious Diseases. 2000; 31: 347-382.
 
 
 
 
 
3

Sources for the information on this page:
  1. Metlay JP, Kapoor WN, Fine MJ.Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination.Journal of the American Medical Association. 1997; 278: 1440-1445.
  2. Mandell LA, Marrie TJ, Grossman RF, et al.Canadian guidelines for the initial management of community-acquired pneumonia: an evidence-based update by the Canadian Infectious Diseases Society and the Canadian Thoracic Society.Clinical Infectious Diseases. 2000; 31: 383-421.
  3. Bartlett JG, Dowell SF, Mandell LA, et al.Practice guidelines for the management of community-acquired pneumonia in adults.Clinical Infectious Diseases. 2000; 31: 347-382.
This information was last updated on Jan 07, 2009
BMJ Group
This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.
Next in this section: How common is it?