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Hospital-acquired pneumonia physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]

Overview

Physical examination is important in diagnosing hospital-acquired pneumonia, finding include fever, tachypnea, rhonchi, crackles and wheezes. For ventilator-associated pneumonia, a deterioration in ventilator parameters such as, tachypnea, decreased tidal volume, increased minute ventilation, or decreased oxygen saturation could be the first indicators of a new onset ventilator-associated pneumonia.^[1]

Physical Examination

**Criteria for Tachypnea**^[2]
Age	Breaths/min

< 2 months	> 60
2-12 months	> 50
1- 5 years	> 40
> 5 years	> 20

Vitals

Lungs

Palpation

Increased tactile fremitus

Percussion

Dullness on percussion

Auscultation

Decreased breath sounds
Bronchial breath sounds
Rhonchi
Crackles, Rales
Increased vocal fremitus

References

↑ Koenig, S. M.; Truwit, J. D. (2006). “Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention”. Clinical Microbiology Reviews. 19 (4): 637–657. doi:10.1128/CMR.00051-05. ISSN 0893-8512.
↑ Russell, G. (2001). “Community acquired pneumonia”. Archives of Disease in Childhood. 85 (6): 445–446. doi:10.1136/adc.85.6.445. ISSN 0003-9888.

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