Applicable patient: immunocompetent adult with clinical pneumonia, confirmed by chest radiograph
Questions:
(1) Does the patient have extra-pulmonary features?
(2) Does the patient have a history of a zoonotic contact prior to onset of the pneumonia?
(3) Is relative bradycardia present?
Criteria for use of relative bradycardia as diagnostic tool:
(1) The temperature of the patient is >= 102°F,
(2) The age of the patient is >= 13 years.
(3) The patient not receiving beta blockers.
(4) The patient does not have cardiac arrhythmias or a pacemaker.
If no extra-pulmonary features are present, then the pneumonia is probably a typical bacterial pneumonia and consider initially:
(1) Streptococcus pneumoniae
(2) Hemophilus influenzae
(3) Moraxella catarrhalis
(4) Streptococcus pyogenes (Group A streptococcus)
(5) Klebsiella pneumoniae
(6) aspiration pneumonia
If extra-pulmonary features are present then the pneumonia is probably an atypical pneumonia.
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Zoonotic Contact
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Relative Bradycardia
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Possible Organisms
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present
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present
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psittacosis
Q fever
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present
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absent
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tularemia
|
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absent
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present
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Legionnaires' disease
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absent
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absent
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Mycoplasma pneumoniae
Chlamydia pneumoniae
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