DIAGNOSIS CHECKLIST
for Pneumonia

Why: e.g. cough, phlegm, blood-stained phlegm, shortness of breath, fever, chest pain.

Why: may be complicated by pneumonia.

Why: e.g. influenza, cigarette smoking, alcohol excess, bronchiectasis, cystic fibrosis, lung cancer, AIDS, treatment with anti- cancer drugs and intravenous drug abuse.

Why: increased risk of pneumonia with influenza, bronchiectasis, cystic fibrosis, lung cancer and AIDS; recurrent lung infections from childhood may suggest cystic fibrosis or bronchiectasis; bronchiectasis may be caused by whooping cough, measles, tuberculosis, inhaled foreign body (e.g. peanut in child), lung cancer and cystic fibrosis; aspiration pneumonia may occur as a result of tracheo-esophageal fistula, reflux oesophagitis, esophageal stricture or in bulbar palsy.

Why: e.g. treatment with anti-cancer medications increase the risk of pneumonia from organisms such as P. Carinii, Mycobacterium avium intracellulare and cytomegalovirus.

Why: e.g. cystic fibrosis; anyone in the family had tuberculosis or a chronic cough.

Why: number of packets per day and number of years you have smoked. Smoking is a major cause of lung cancer, chronic bronchitis and emphysema. Smoking is also a major risk factor for pneumonia. Passive smoking exposure is also regarded as a significant risk.

Why: The drinking of large amounts of alcohol in binges can sometimes result in aspiration pneumonia and alcoholics are also prone to develop pneumococcal or Klebsiella pneumonia.

Why: e.g. intravenous drug users are at risk of developing pneumonia from Staph. Aureus bacteria.

Why: e.g. to establish the risk of tuberculosis need to enquire about travel history and immigrant status. Travel history is also important if considering possibility of respiratory syncytial virus, SARS and typhoid fever.

Why: e.g. exposure to animals may suggest Q fever or psittacosis.

Why: If there is sputum production, describe it? - e.g. copious amounts with offensive smell suggests bronchiectasis; pus-like sputum may suggest pneumonia, abscess, tuberculosis or bronchiectasis; rusty colored sputum suggests lobar pneumonia due to Strep. Pneumoniae bacteria.

Why: may occur with pneumonia. However, must also consider the diagnoses of chronic bronchitis, tuberculosis, bronchiectasis, lung cancer, lung metastasis, foreign body, left ventricular failure and mitral stenosis.

Why: In acute cases may suggest pneumonia, however must also consider the alternative diagnoses of congestive heart failure and pulmonary embolism. In chronic cases may suggest emphysema, chronic pulmonary fibrosis, chronic congestive heart failure, tuberculosis and lung cancer.

Why: may suggest foreign body, whooping cough.

Why: may suggest bacterial or viral pneumonia, tuberculosis, lung abscess, lung cancer or lung infarction. Fever at night may suggest tuberculosis, pneumonia or mesothelioma (tumor of lung lining due to asbestos exposure).

Why: may suggest lung cancer, tuberculosis, cystic fibrosis.

Why: e.g. fever, sharp chest pain worse with coughing and breathing, green sputum, shortness of breath. May have blood stained sputum.

Why: e.g. fever, malaise, headache, dry cough. Minimal shortness of breath.

Why: e.g. productive cough on most days for at least three months of the year for at least two consecutive years, shortness of breath, wheeze. May be complicated by pneumonia (especially due to Haemophilus influenza).

Why: e.g. weight loss, cough, blood in sputum, shortness of breath, chest pain (often mild), wheeze, reduced appetite. May have symptoms of cancer having spread to brain, bones and liver. Lung cancer may be complicated by pneumonia.

Why: e.g. chronic cough which is worse on waking; copious amounts of yellow or green phlegm with offensive smell; persistent bad breath; phlegm may be blood stained. Complicated by recurrent episodes of pneumonia.

Why: e.g. cough; sputum production which is clear early in disease and pus-like later in disease; sputum may be blood stained; shortness of breath; pleuritic chest pain; tiredness; poor appetite; weight loss; low grade fever; night sweats.

Why: e.g. illness usually starts abruptly with a fever, headache, chills and muscle aches. This is followed by sore throat, dry cough and runny nose. Influenza may be complicated by bacterial pneumonia (usually Strep. Pneumoniae).