Pneumonia diagnostic criteria

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Hamid Qazi, MD, BSc [2], Priyamvada Singh, M.D. [3]

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## Overview

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Community acquired pneumonia should be distinguished from healthcare-associated pneumonia as these diseases have different causative organism, prognosis, diagnostic and treatment guidelines.

## Diagnostic Criteria

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### Community-Acquired pneumonia

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Patient who has not been hospitalized or in an institutional setting for the past 2 weeks and have the following findings:

* CXR findings of a new infiltrate. Although there is no gold standard for the diagnosis of community acquired pneumonia (CAP), a new infiltrate on chest radiograph in the setting of acute respiratory complaints (e.g., cough and dyspnea) is considered highly suggestive of CAP.
* At least 2 of the four need to be present. The four symptoms are fever, cough, dyspnea, chest pain.

### Hospital Acquired Pneumonia

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According to the Infectious Diseases Society of America and the American Thoracic Society healthcare-associated pneumonia includes any patient who meet the below criteria [1]

* Hospitalized in an acute care hospital for 2 or more days within 90 days of the infection;
* Resided in a nursing home or long-term care facility;
* Received recent intravenous antibiotic therapy, chemotherapy, or wound care within the past 30 days of the current infection;
* Attended a hospital or hemodialysis clinic.

## Infectious Diseases Society of America/American Thoracic Society consensus recommendation criteria for severe community acquired pneumonia in adults. [2] (DO NOT EDIT)

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### Minor Criteria

* Respiratory rate >30 breaths/min
* PaO2/FiO2 ratio <250
* Multilobar infiltrates
* Confusion/disorientation
* Uremia (BUN level, >20 mg/dL)
* Leukopenia (WBC count, <4000 cells/mm3)
* Thrombocytopenia (platelet count, < 100,000 cells/mm3)
* Hypothermia (core temperature, <36 degrees C)
* Hypotension requiring aggressive fluid resuscitation

### Major criteria

* Invasive mechanical ventilation
* Septic shock with the need for vasopressors

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## References

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1. ↑ Attridge RT, Frei CR (2011). "Health care-associated pneumonia: an evidence-based review". The American Journal of Medicine. 124 (8): 689–97. doi:10.1016/j.amjmed.2011.01.023. PMID 21663884. Retrieved 2012-09-02. Unknown parameter `|month=` ignored (help)
2. ↑ Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Musher DM, Niederman MS, Torres A, Whitney CG (2007). "Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults". Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 44 Suppl 2: S27–72. doi:10.1086/511159. PMID 17278083. Retrieved 2012-09-06. Unknown parameter `|month=` ignored (help)CS1 maint: Multiple names: authors list (link)

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