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Literatur-Übersicht
Does this patient have community-acquired pneumonia? Diagnosing
pneumonia by history and physical examination.
Autor – Metlay JP; Kapoor
WN; Fine MJ
Zeitschrift/Erscheinungsdatum –
JAMA 1997 Nov 5;278(17):1440-5.
STUDY OBJECTIVES:
Community-acquired pneumonia is an important cause of acute respiratory
symptoms (eg, cough) in the ambulatory care setting. Distinguishing pneumonia
from other causes of respiratory illnesses, such as acute bronchitis and
upper respiratory tract infections, has important therapeutic and prognostic
implications. The reference standard for diagnosing pneumonia is chest
radiography, but it is likely that many physicians rely on the patient's
history and their physical examination to diagnose or exclude this disease.
A review of published studies of patients suspected of having pneumonia
reveals that there are no individual clinical findings, or combinations
of findings, that can rule in the diagnosis of pneumonia for a patient
suspected of having this illness. However, some studies have shown that
the absence of any vital sign abnormalities or any abnormalities on chest
auscultation substantially reduces the likelihood of pneumonia to a point
where further diagnostic evaluation may be unnecessary. This article reviews
the literature on the appropriate use of the history and physical examination
in diagnosing community-acquired pneumonia.
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