General Facts and Figures Classification Presentation History Physical Exam Labs Radiology Diagnosis Criteria for diagnosis Differential Microbiology General Specific organisms Pharmacology Drug classes Mechanism of action Resistance Treatment General Site of care Medication Duration Assessment of response Prevention References Literature cited Complete bibliography Links More...		Presentation History patients can present with many different complaints, signs and symptoms common complaints include dyspnea, fever, cough (productive or non-productive), chills, chest pain, myalgias, headache important things to note in the history include: age of patient, presence of comorbidities, underlying medical conditions, sick contacts, unusual environmental exposures, social support it is usually not possible to determine the etiologic agent based on history but some clues can be gleaned from it (Table 1) TABLE 1. Clues from the history (adapted from the IDSA guidelines and Karetzky) 6, 7 CONDITIONS COMMONLY ENCOUNTERED PATHOGENS children, young adults influenza, M. pneumoniae, C. pneumoniae COPD/smoking S. pneumoniae, H. influenzae, M. catarrhalis, Legionella nursing-home residence S. pneumoniae, gram-negative bacilli, H. influenzae, S. aureus, anaerobes (aspiration), C. pneumoniae poor dental hygiene anaerobes epidemic Legionnaire's disease Legionella species exposure to bats or soil enriched with bird droppings Histoplasma capsulatum exposure to birds Chlamydia psittaci exposure to rabbits Francisella tularensis HIV infection PCP, S. pneumoniae, H. influenzae, M. tuberculosis, MAI travel to the southwestern US Coccidiodes immitis exposure to farm animals or parturient cats Coxiella burnetti (Q fever) influenza active in community influenza, S. pneumoniae, S. aureus, S. pyogenes, H. influenzae suspected large-volume aspiration anaerobes, chemical pneumonitis structural lung disease P. aeruginosa, Burkholderia (Pseudomonas) cepacia, S. aureus injection drug use S. aureus, anaerobes, M. tuberculosis airway obstruction anaerobes Footnotes: 6) Bartlett JG, Breiman RF, Mandell LA, File TM Jr., Community-acquired pneumonia in adults: guidelines for management, The Infectious Diseases Society of America, Clinical Infectious Diseases, 1998 Apr, 26(4):811-38. 7) Karetzky M, Burke AC, Brandstetter RD, The Pneumonias, Springer-Verlag, New York, 1993.

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