Bacterial pneumonia physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S

Although physical examination may differ amongst patients, many present with similar findings. Variations may be due to the severity and extent of disease, the causative bacteria, as well as the presence or absence of any complications.^[1] Much of the systemic examination may appear to be normal, with the exception of some, in cases of specific infections. All patients present with significant pulmonary findings and changes in vital signs. With the development of complications such as sepsis, neurological findings such as confusion can also develop.

Patients may appear normal or in distress. Varying degrees of cyanosis may be present.

• Pulse: > 100/minute
• Temperature: > 38 C/100.4 F or < 35 C/95 F
• Respiratory Rate: 18 breaths/minute

• Dental illnesses may predispose to an Anaerobic infection

• Cyanosis may be present

• Tachycardia (> 100/minute)
• Bradycardia may be found in cases of Legionella

• Breath sounds: bronchial breath sounds as well as crackles and rales
• Percussion: dull
• Egophony: increased
• Fremitus: tactile/ increased
• Tracheal Deviation: often absent
• Other findings: lymphadenopathy

• Patients may present with confusion, especially the elderly or patients that develop sepsis

• No significant findings

• Diarrhea may indicate a Legionella infection^[2]

• No significant findings; patients often complain of myopathy

• No significant findings

• Hemolytic anemia may be seen with Mycoplasma infections^[3]

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