Abstract
The diagnosis of hospital-acquired pneumonia (HAP) is complicated and clinically challenging in the case of ventilated patients [1]. HAP is clinically diagnosed in patients who have been hospitalized for at least 48 hours and ventilator-associated pneumonia (VAP) is clinically diagnosed in patients who are ventilated and pneumonia develops at least 48 hours after endotracheal intubation. The subsequent presentation of a new opacity on the chest radiograph and presence of two or more clinical features, including fever, leukopenia or leukocytosis, hypoxemia, and purulent respiratory secretions [2], are required for clinical diagnosis of pneumonia.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Grossman R, Baughman RP, Campbell GD, et al. Evidence-based assessment of diagnostic tests for ventilator-associated pneumonia: report of the clinical practice guideline panel. Chest. 2000;117:177–218.
Nair GB, Niederman MS. Nosocomial pneumonia: lessons learned. Crit Care Clin. 2013;29:521–546.
American Thoracic Society and Infectious Diseases Society of America. Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcareassociated Pneumonia. Am J Respir Crit Care Med. 2005:171:388–416.
Sirvent JM, Vidaur L, Gonzalez S, et al. Microscopic examination of intracellular organisms in protected bronchoalveolar mini-lavage fluid for the diagnosis of ventilator-associated pneumonia. Chest. 2003;123:518–523.
Taylor GD, Buchanan-Chell M, Kirkland T, McKenzie M, Wiens R. Bacteremic nosocomial pneumonia. A 7-year experience in one institution. Chest. 1995;108:786–788.
Rello J, Gallego M, Mariscal D, Sonora R, Valles J. The value of routine microbiologic investigation in the diagnosis of ventilator-associated pneumonia. Am J Respir Crit Care Med. 1997;156:196–200.
Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/ American Thoracic Society consensus guidelines on the management of communityacquired pneumonia in adults. Clin Infect Dis. 2007;44 (Suppl 2):S27–S72.
Simonetti AF, Viasus D, Garcia-Vidal C, Carratala J. Management of community-acquired pneumonia in older adults. Ther Adv Infect Dis. 2014;2:3–16.
Menendez R, Torres A, Aspa J, Capelastegui A, Prat C, Rodriguez de CF. [Community acquired pneumonia. New guidelines of the Spanish Society of Chest Diseases and Thoracic Surgery (SEPAR)]. Arch Bronconeumol. 2010;46:543–558.
Levin KP, Hanusa BH, Rotondi A, et al. Arterial blood gas and pulse oximetry in initial management of patients with community-acquired pneumonia. J Gen Intern Med. 2001;16:590–598.
Fine MJ, Auble, Yealy, et al. A prediction rule to identify low-risk patients with communityacquired pneumonia. N Engl J Med. 1997;336:243–250.
Fine MJ, Smith MA, Carson CA, et al. Prognosis and outcomes of patients with communityacquired pneumonia. A meta-analysis. JAMA. 1996;275:134–141.
Garau J, Baquero F, Perez-Trallero E, et al. Factors impacting on length of stay and mortality of community-acquired pneumonia. Clin Microbiol Infect. 2008;14:322–329.
Lim WS, Baudouin SV, George RC, et al. BTS guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009;64 (Suppl 3):iii1–55.
Woodhead M, Blasi F, Ewig S, et al. Guidelines for the management of adult lower respiratory tract infections–full version. Clin Microbiol Infect. 2011;17 (Suppl 6):E1–59.
Cillóniz C, Torres A, Polverino E, et al. Community-acquired lung respiratory infections in HIVinfected patients: microbial aetiology and outcome. Eur Respir J. 2014;43:1698–1708.
Viasus D, Garcia-Vidal C, Castellote J, et al. Community-acquired pneumonia in patients with liver cirrhosis: clinical features, outcomes, and usefulness of severity scores. Medicine (Baltimore). 2011;90:110–118.
Waterer GW, Wunderink RG. The influence of the severity of community-acquired pneumonia on the usefulness of blood cultures. Respir Med. 2001;95:78–82.
Cillóniz C, Polverino E, Ewig S, et al. Impact of age and comorbidity on cause and outcome in community-acquired pneumonia. Chest. 2013;144:999–1007.
Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med. 2002;165:867–903.
Roson B, Carratala J, Fernandez-Sabe N, Tubau F, Manresa F, Gudiol F. Causes and factors associated with early failure in hospitalized patients with community-acquired pneumonia. Arch Intern Med. 2004;164:502–508.
Andreo F, Dominguez J, Ruiz-Manzano J, et al. Usefulness of pneumococcal antigen detection in pleural fluid samples by immunochromatographic assay for diagnosis of pneumococcal pneumonia. Clin Microbiol Infect. 2006;12:682–684.
Falguera M, Lopez A, Nogues A, Porcel JM, Rubio-Caballero M. Evaluation of the polymerase chain reaction method for detection of Streptococcus pneumoniae DNA in pleural fluid samples. Chest. 2002;122:2212–2216.
Roson B, Carratala J, Verdaguer R, Dorca J, Manresa F, Gudiol F. Prospective study of the usefulness of sputum Gram stain in the initial approach to community-acquired pneumonia requiring hospitalization. Clin Infect Dis. 2000;31:869–874.
Anevlavis S, Petroglou N, Tzavaras A, et al. A prospective study of the diagnostic utility of sputum Gram stain in pneumonia. J Infect. 2009;59:83–89.
Blot F, Raynard B, Chachaty E, Tancrede C, Antoun S, Nitenberg G. Value of gram stain examination of lower respiratory tract secretions for early diagnosis of nosocomial pneumonia. Am J Respir Crit Care Med. 2000;162:1731–1737.
Cook D, Mandell L. Endotracheal aspiration in the diagnosis of ventilator-associated pneumonia. Chest. 2000;117:195S–197S.
Emonet S, Shah HN, Cherkaoui A, Schrenzel J. Application and use of various mass spectrometry methods in clinical microbiology. Clin Microbiol Infect. 2010;16:1604–1613.
Miller MB, Tang YW. Basic concepts of microarrays and potential applications in clinical microbiology. Clin Microbiol Rev. 2009;22:611–633.
Murdoch DR. Nucleic acid amplification tests for the diagnosis of pneumonia. Clin Infect Dis. 2003;36:1162–1170.
Aujesky D, Fine MJ. The Pneumonia Severity Index: A Decade after the Initial Derivation and Validation. Clin Infect Dis. 2008;47 (Suppl 3):S133–S139.
Marrie TJ, Huang JQ. Admission is not always necessary for patients with communityacquired pneumonia in risk classes IV and V diagnosed in the emergency room. Can Respir J. 2007;14:212–216.
Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58:377–382.
Aliberti S, Ramirez J, Cosentini R, et al. Low CURB-65 is of limited value in deciding discharge of patients with community-acquired pneumonia. Respir Med. 2011;105:1732–1738.
Cillóniz C, Ewig S, Polverino E, et al. Community-acquired pneumonia in outpatients: aetiology and outcomes. Eur Respir J. 2012;40:931–938.
Falguera M, Sacristan O, Nogues A, et al. Nonsevere community-acquired pneumonia: correlation between cause and severity or comorbidity. Arch Intern Med. 2001;161:1866–1872.
Cillóniz C, Ewig S, Polverino E, et al. Microbial aetiology of community-acquired pneumonia and its relation to severity. Thorax. 2011;66:340–346.
Charles PG, Wolfe R, Whitby M, et al. SMART-COP: a tool for predicting the need for intensive respiratory or vasopressor support in community-acquired pneumonia. Clin Infect Dis. 2008;47:375–384.
Marti C, Garin N, Grosgurin O, et al. Prediction of severe community-acquired pneumonia: a systematic review and meta-analysis. Crit Care. 2012;16:R141.
Arancibia F, Bauer TT, Ewig S, et al. Community-acquired pneumonia due to gram-negative bacteria and pseudomonas aeruginosa: incidence, risk, and prognosis. Arch Intern Med. 2002;162:1849–1858.
Cillóniz C, Ewig S, Ferrer M, et al. Community-acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis. Crit Care. 2011;15:R209.
Hyvernat H, Pulcini C, Carles D, et al. Fatal Staphylococcus aureus haemorrhagic pneumonia producing Panton-Valentine leucocidin. Scand J Infect Dis. 2007;39:183–185.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Torres, A., Cillóniz, C. (2015). Diagnosis and classification of Pneumonia. In: Clinical Management of Bacterial Pneumonia. Adis, Cham. https://doi.org/10.1007/978-3-319-22062-8_4
Download citation
DOI: https://doi.org/10.1007/978-3-319-22062-8_4
Published:
Publisher Name: Adis, Cham
Print ISBN: 978-3-319-22061-1
Online ISBN: 978-3-319-22062-8
eBook Packages: MedicineMedicine (R0)