Sign & Symptoms of Pneumonia

Symptoms of pneumonia caused by bacteria in otherwise healthy people (younger than 65) usually come on suddenly. They often start during or after an upper respiratory infection, such as influenza or a cold, and may include:

• Cough, often producing mucus (sputum) from the lungs. Mucus may be rusty or green or tinged with blood.
• Fever which may be less common in older adults.
• Shaking, "teeth-chattering" chills (one time only or many times).
• Fast, often shallow, breathing and the feeling of being short of breath.
• Chest wall pain that is often made worse by coughing or breathing in.
• Fast heartbeat.
• Feeling very tired (fatigue) or feeling very weak (malaise).
• Nausea and vomiting.
• Diarrhea

Clinical signs of pneumonia are characteristic and are referred to clinically as consolidation :

• Expansion : reduced on the affected side
• Vocal fremitus : increased on the affected side (in other chest disease this sign is of very little use!)
• Percussion : dull
• Breath sounds : bronchial breath sounds
• Additional sounds : medium, late or pan-inspiratory crackles
• Vocal resonance : increased
• Pleural rub : may be present

Investigation for Pneumonia

Imaging Test
1. X-ray
-A chest X-ray should be obtained to confirm the diagnosis of pneumonia, help guide initial treatment, and exclude other etiologies.

Chest X-ray showing right inferior lobar pneaumonia

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2. CT Scan
-may be helpful in differentiating between lung abscess and empyema* when the chest X-ray is equivocal
*Empyema is a collection of pus in the space between the lung and the inside of the chest wall (pleural space).


Laboratory Test
1. Blood test- access white blood cell count
-An individual's white blood cell count can often give a hint as to the severity of the pneumonia and whether it is caused by bacteria or a virus. An increased number of neutrophils is seen in bacterial infections, whereas an increase in lymphocytes, is seen in viral infections, fungal infections, and some bacterial infections (like tuberculosis).

2. Culture of sputum/Gram’s staining-Sputum samples can be collected and examined under the microscope. If the pneumonia is caused by bacteria or fungi, the organisms can often be detected by this examination

3. Arterial blood gases-access for oxygen saturation to determine severity of respiratory illness.