[Physical examination of the lungs in suspected pneumonia].
Tjeerd O H de Jongh, Henk A Thiadens
Abstract
Tjeerd O H de Jongh, Henk A Thiadens
Abstract
Physical examination of the lungs is easy to perform, but the interobserver agreement is poor due to lack of standardisation in the findings. The use of an electronic stethoscope with computerised analysis of the lung sounds might improve diagnostic accuracy. General signs such as fever and an accelerated respiratory and pulse rate increase the probability of a pneumonia. Percussion dullness increases the probability of pneumonia, but its absence does not exclude a pneumonia. Bronchial or decreased breath sounds or crackles increase the probability of pneumonia, but their absence does not exclude a pneumonia. There are no physical diagnostic findings that have a very high predictive value for a pneumonia; all findings should therefore be combined.
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Physical examination of the lungs is easy to perform, but the interobserver agreement is poor due to lack of standardisation in the findings. The use of an electronic stethoscope with computerised analysis of the lung sounds might improve diagnostic accuracy. General signs such as fever and an accelerated respiratory and pulse rate increase the probability of a pneumonia. Percussion dullness increases the probability of pneumonia, but its absence does not exclude a pneumonia. Bronchial or decreased breath sounds or crackles increase the probability of pneumonia, but their absence does not exclude a pneumonia. There are no physical diagnostic findings that have a very high predictive value for a pneumonia; all findings should therefore be combined.
Key concepts: Crackles, Medicine, Pneumonia, Stethoscope, Physical examination, Lung, Auscultation, Intensive care medicine