Community-acquired pneumonia history and symptoms

Common symptoms of pneumonia include cough, fever, dyspnea, and chest pain. Atypical symptoms include arthralgia, headaches, fatigue, nausea, vomiting, and diarrhea. Elderly patients do not always show the classical signs of pneumonia, and may often present with delirium, confusion, falls, and hypothermia.

Important components in a patient’s history when he/she is presenting with symptoms suggestive of pneumonia include:

• Duration of symptoms
• Fever pattern
• Productive or dry cough
• Characteristics of sputum
• Presence of chest pain
• Presence of hemoptysis
• Recent sick contacts
• Travel history
• Smoking history
• History of other pulmonary conditions
• Recent hospital/health-care facility admission
• Antibiotic use

• The common features of community acquired pneumonia are:

1. Fever
2. Cough
3. Chest pain mainly pleuritic type
4. Dyspnea
5. Sputum production

• Sputum color may help in detecting the causative agent of the pneumonia.

1. Mucopurulent is a typical feature suggesting bacterial etiology
2. Watery or clear fluid points out towards atypical bacteria and virus.
3. Rusty coloured sputum is more typical of pneumococal pneumonia.
4. Rapid, shallow breathing

• The other atypical or less common features of pneumonia are:^[1]

1. Fever with chills or rigors
2. Other system may also be involved like gastrointestinal which present with nausea, vomiting and diarrhea.
3. If pneumonia is very severe the patient may also have altered consciousness.

• Anorexia
• Arthralgia
• Cyanosis
• Fatigue
• Headaches
• Hemoptysis
• Myalgia

The manifestations of pneumonia, like those for many conditions, might not be typical in older people. They may instead experience:

• Confusion^[2]
• Delirium
• Falls
• Hypothermia

• Increased sleepiness
• Jaundice
• Feeding difficulties^[3]

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