TY  - CHAP
M1  - Book, Section
TI  - Approach to Pulmonary Infection in the Immunocompetent Host
A1  - Curtis, Megan Rose
A1  - Jhaveri, Tulip Ajit
A1  - Kotton, Camille Nelson
A2  - Grippi, Michael A.
A2  - Antin-Ozerkis, Danielle E.
A2  - Dela Cruz, Charles S.
A2  - Kotloff, Robert M.
A2  - Kotton, Camille Nelson
A2  - Pack, Allan I.
PY  - 2023
T2  - Fishman’s Pulmonary Diseases and Disorders, 6e
AB  - Pneumonia  is  defined  as  inflammation  of  the  pulmonary  parenchyma  caused  by  an  infectious  agent.  In  the  fifth  century  BC,  Hippocrates  and  his  pupils  first  observed  the  cardinal  symptoms  of  pneumonia:  productive  cough,  fever,  and  dyspnea.  He  pioneered  the  use  of  auscultation,  comparing  the  oscillations  between  the  hemithoraces  to  diagnose  lower  respiratory  tract  infections.1  Despite  millennia  of  medical  advances,  pneumonia  continues  to  cause  significant  morbidity  and  represents  the  leading  cause  of  infection-related  mortality  worldwide.2  Clinicians  still  rely  primarily  on  history  and  physical  examination  when  caring  for  a  patient  with  suspected  pneumonia.  The  clinical  presentation  of  pneumonia  is  vastly  heterogenous  and  may  include  fever  or  hypothermia;  sweats;  rigors  (chills);  pulmonary  symptoms  such  as  cough,  sputum  production,  dyspnea,  or  pleurisy;  and  pulmonary  lesions  observed  on  radiographic  examination.  Nonspecific  symptoms  are  common,  including  loss  of  appetite,  fatigue,  and  confusion.  The  classic  findings  on  physical  examination  include  “crackles”  or  “rales”;  however,  the  accuracy  of  clinical  signs  and  symptoms  alone  have  been  shown  to  be  ineffective  in  successfully  diagnosing  pneumonia.3  Radiographs  assist  in  identifying  a  pulmonary  lesion;  however,  findings  may  be  nonspecific.  Because  there  are  no  diagnostic  tests  available  to  identify  the  microbiologic  etiology  immediately  upon  presentation  (besides  those  for  viral  causes),  initial  antibiotic  treatment  is  empiric  and  should  be  started  as  soon  as  pneumonia  is  suspected.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/24
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1206603388
ER  -