Bronchial Pneumonia Diagnosis

The diagnosis of bronchial pneumonia depends on the type of pneumonia contracted.

History:

1. Symptoms
2. Illnesses
3. Surgeries
4. Medications
5. Habits
6. Travel
7. Hobbies
8. Allergies
9. Occupation

Physical symptoms :

1. Rash on skin
2. Increased respiration (number of breaths per minute) and heart rate
3. Blood pressure may be low
4. Presence of fever
5. The rib cage may experience difficulty in expanding
6. Abnormal or altered breath sounds (friction rub, rales, crackles, wheezing) due to the damage to lung tissue, presence of fluid or pus and the narrowing of airways
7. Change in mental state – anxiety, mood swings, confusion.

Tests:

1. Sputum samples may be needed to be collected and sent to the lab for microscopic analysis by treating with special stains to reveal the particular bacteria.
2. Sputum could be tested for growth of cultures and sent for microscopic analysis to identify the organism and check for sensitivity to antibiotics by using special stain tests.
3. Cultures may take from 48 hours in case of bacteria to several weeks (TB).
4. Viral cultures can also be taken
5. Blood samples would be collected and tested for bacterial cultures (show as positive in 8-20% of B.p)
6. 6. Blood test may reveal high ESR (viral), although white blood cell count may be normal in the elderly and low in viral pneumonia, low Sodium levels (empyema or lung Abscess), high LDH (PCP), low oxygen levels (hypoxia), and acidity (acidosis)
7. In case of mycoplasma pneumonia, high levels of IgM antibodies would be detected 1-2 weeks after infection in almost 80% of the patients.
8. Organisms like viruses (herpes, Influenza, RSV) can be identified by doing throat swabs using a sterile Q-tip. They can also be detected by performing tracheal aspiration consisting of sucking secretions from the trachea with a suction tube.
9. In case of PCP, an HIV test will be advocated – in case of the presence of an HIV infection, CD4 cell count falls to below 200.
10. Pictures of lung could be recommended
11. Chest x-rays may reveal infection in the lobes of the lungs (B.p.), may show diffused pattern of infection (PCP, V.p, M.p), and effusions.
12. Unless cancer or abscess is suspected, a CAT scan or MRI is rarely required
13. Your doctor may consult an infectious diseases specialist or a pulmonologist for a second opinion.

Recommendations of the pulmonologist may include:

1. Bronchoscopy- A flexible tube with a camera at the tip is inserted through the mouth into the lungs, to take a sample of secretions ofr biopsy or culture.
2. Thoracentesis is carried out by inserting a needle between the ribs to extract a sample of the fluids for analysis. This is performed in case of effusions and empyema.