Community-Acquired Pneumonia CAP Diagnosis

 

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.

Zoonotic Contact	Relative Bradycardia	Possible Organisms
present	present	psittacosis Q fever
present	absent	tularemia
absent	present	Legionnaires' disease
absent	absent	Mycoplasma pneumoniae Chlamydia pneumoniae