Pneumonia Question

Today I had a 46 y/o with probable pneumonia. The patients wife asked if it was Viral or Pneumonia. If you don't have a sputum sample--how can you tell if its pneumonia or Virus?

He came in with temp 100. Productive clear cough with blood streaken phlegm. SOB with exertion.

i need clarification........do you mean viral pneumonia or bacterial pneumonia?

if that is what you mean, you would need either a blood or sputum sample to distinguish between the two.

Today I had a 46 y/o with probable pneumonia. The patients wife asked if it was Viral or Pneumonia. If you don't have a sputum sample--how can you tell if its pneumonia or Virus?

He came in with temp 100. Productive clear cough with blood streaken phlegm. SOB with exertion.

Ah comon you know the anwer to this. Pneumonia can be either viral or bacterial, AND can be from chemical or mechanical irritation, (which is neither viral nor bacterial).

I know you have not forgotten that aspiration for example, causes pneumonia that is neiter bacterial nor viral.

or look at his wbc

Good question, and I'm not sure I know. Viral pneumonia usually starts as the flu, and they have a history of flu like symptoms such as body aches, fever, etc. A rapid flu nasal test could determine this.

Bacterial pneumonia presents with the repiratory systems, chest pain, sob, etc. A sputum culture with rapid gram stain can help diagnose this.

Does your hospital have a policy of checking for the flu on flu-like symptoms? This person might need to be put on droplet precautions. Pink tinged sputum can be pneumonia or pulmonary edema, but blood sputum might need to be ruled out for tb and an afb should be done and the patient isolated.

I'm no expert, just babbling here. Good question.

if you take sample the results show the cause e.g. if WBC increased the cause is bacterial ,, and if it decreased the cause is virus .

Also... a viral respiratory/chest infection can 'invite' a secondary bacterial pneumonia...which is the most common form of pneumonia caused by flu, etc.(bacterial pneumonia SECONDARY to viral infection)...

A 'true' viral pneumonia thats bad enough to get you admitted to hospital is rare...or at least much less common than bacterial.

And, a viral pneumonia typically (though not always) has a different pattern on chest-films. The x-rays will usually show diffuse/wide-spread infiiltrates, whereas a bacterial pneumonia will 'typically' appear as a dense, localized consolidation (at least initially. a bacterial pneumonia that evolves into a more diffuse pattern can herald ARDS)...BUt these are genralizations...