A doctor who suspects pneumonia begins by thoroughly checking the personís medical history and a physical examination. Bacterial pneumonia affects suddenly; the person suffers cough which is accompanied by mucus that is colored or rusty, fever, and pain along the chest wall.
Infections caused by bacteria (Mycoplasma pneumonia) and viruses start to aggravate and develop after a few days of flu-like symptoms or cold-like symptoms. They can cause a headache, pain under the breastbone, and hacky or barky cough.
The Physical Examination
The very necessary diagnostic tool for pneumonia may be the stethoscope. In pneumonia, when air passes through mucous and fluids in the lungs, it produces sounds called rales and rhonchi. The doctor will definitely suspect pneumonia if he/she hears rales on one side of the chest and while the patient is lying down.
With the diagnostic tool 'percussion', the doctor may tap lightly on the personís chest. This usually produces a drum like sound, but a dull thud indicates inflammation and that the lung has become firm and elastic, called consolidation; or that between the layers of the lung membrane, called pleural effusion, fluid may be collecting.
Several tests may be ordered to aid diagnosis:
- Chest X-rays will show signs of infection in the lungs. Different types of pneumonia will often have different X-ray patterns.
- To determine the organism that is causing pneumonia and to collect a specimen, blood and sputum tests may be performed.
- A lung biopsy may be performed in severe cases.
Other Diagnostic Procedures
In persons with life-threatening pneumonia more strong diagnostic procedures may be required.
- Thoracentesisis done to extract and analyze fluid from the pleura Ė the thin membrane that lines the outside of the lung and the chest cavity. Any collection of fluids in between the layers of pleura is called a pleural effusion. Fluid in pleura is extracted by inserting a thin long needle in between the ribs and analyzed in the laboratory.
- If the physician wants to see inside the lungs, a bronchoscopy may be performed. In this test, a tube is inserted through the nose or mouth. The tube acts like a telescope into the respiratory system, allowing the physician to view the wind-pipe and airways for pus, abnormal mucous, or other problems.
- The physician would use ask you to breathe into an instrument called a spirometer that measures the amount of air you breathe. This test (called spirometry) is helpful in determining how well the lungs are functioning
- Legionella, Mycoplasma, and Chlamydia, Some of the bacteria that can cause pneumonia, cannot be seen with an ordinary microscope. They are identified using special culture techniques or by performing blood tests that detect antibodies to the organisms.
- Aspiration pneumonia causes changes in the chest X-ray that can be seen 6 to 24 hours after inhalation. Symptoms are respiratory distress indicated by grunting, cough, and fever after the aspiration of hydrocarbons, foreign substances, or bodily fluids. Symptoms may develop in minutes or in hours depending on the amount and nature of the breathed in substance