4/13/2023 0 Comments Pneumonia physical exam findings![]() It is therefore essential for the general practitioner (GP) to correctly identify and treat patients with pneumonia and leave those with acute bronchitis without antibiotic prescription. pneumoniae worldwide are now considered as multidrug-resistant. As a consequence of extensive antibiotic use, the incidence of multidrug-resistance has increased alarmingly and up to 30% of S. The most common aetiology of CAP, seen in primary care, is Streptococcus pneumoniae. The prevalence of radiographic pneumonia in outpatients with LRTI has been reported to range between 5% and 21% depending on inclusion criteria. The annual incidence of CAP in Europe is 5–8/1000 residents, of which nearly 80% are managed in primary care. Mortality is higher among hospitalized patients, increases with age, and is higher among men. In the European community the mortality of community-acquired pneumonia (CAP) is less than 1%. Bronchitis is considered a viral disease that is self-limiting in most cases and expectant management is recommended whereas pneumonia, which is a more serious condition, calls for antibiotic therapy, since it is of bacterial aetiology and may be fatal even in young adults. Lower respiratory tract infections (LRTIs) include acute bronchitis and pneumonia. One of the most common reasons for consulting in primary healthcare is acute cough and lower respiratory tract symptoms. When the physician is sure of the diagnosis the judgement is reliable without chest X-ray and antibiotics can be safely prescribed.Ĭhest X-ray can be useful in the assessment of pneumonia in primary care, when the physician is not sure of the diagnosis. There are different guidelines but no consensus on how to manage community-acquired pneumonia in primary care. Conclusion: This study indicates that CXR can be useful if the physician is not sure of the diagnosis, but when sure one can rely on one’s judgement without ordering CXR. Elevated levels of C-reactive protein (CRP) ≥ 50mg/L were associated with the presence of radiographic pneumonia when the diagnosis was suspected ( p < 0.001). When the physicians were sure of the diagnosis radiographic pneumonia was found in 88% of cases ( p < 0.001), when quite sure the frequency of positive CXR was 45%, and when not sure 28%. Results: Radiographic pneumonia was reported in 45% of patients. The outcome of the diagnostic variables and the degree of suspicion was compared with the result of CXR. Main outcome measures: The physicians recorded results of a standardized medical physical examination, including laboratory results, and rated their suspicion into three degrees. Subjects: A total of 103 adult patients with suspected pneumonia in primary care. ![]() Setting: Two primary care settings in Linköping, Sweden. Design: A three-year prospective study was conducted between September 2011 and December 2014. ![]() Objectives: To investigate the diagnostic value of different clinical and laboratory findings in pneumonia and to explore the association between the doctor’s degree of suspicion and chest X-ray (CXR) result and to evaluate whether or not CXR should be used routinely in primary care, when available.
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