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Pneumonia in immunocompromised host - Symptom

Alternative Names

Pneumonia in immunodeficient patient

Symptoms:

Cough (may be dry or produce mucus-like, greenish, or pus-like sputum)
Chills with shaking
Easy fatigue
Fever
General discomfort, uneasiness, or ill feeling (malaise)
Headache
Loss of appetite
Nausea and vomiting
Sharp or stabbing chest pain that gets worse with deep breathing or coughing
Shortness of breath

Other symptoms that may occur:

Excessive sweating or night sweats
Joint stiffness (rare)
Muscle stiffness (rare)
Swollen glands

Signs and tests:

The doctor may hear crackles or other abnormal breath sounds when listening to the chest with stethoscope. Lack of breath sounds can be an important sign, because it may mean there is a buildup of fluid between the chest wall and lung.

Tests may include:

Arterial blood gases
Blood culture
Bronchoscopy
Chest CT scan (in certain cases)
Chest x-ray
Complete blood count
Lung biopsy (in certain cases)
Sputum gram stain
Urine tests (to diagnose Legionnaire's disease)

Reviewed last on: 9/17/2008
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, PhD, MD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Moran GJ, Talan DA. Pneumonia. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2006: chap 75.

Baldwin Dr, Macfarlane JT. Community-acquired pneumonia. In: Cohen J, Powderly WG, eds. Infectious Diseases. 2nd ed. New York, NY: Elsevier; 2004: chap 34.

Donowitz GR, Mandell GL. Acute pneumonia. In: Mandell GL, Bennett Je, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2005: chap 61.

Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007 Mar 1;44 Suppl 2:S27-72.

American Thoracic Society. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005 Feb 15;171(4):388-416.

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