Pneumonia is a type of respiratory infection that can affect one or both lungs. It’s a dangerous condition that accounts for around one million hospital admissions each year and another 140,000 readmissions after initial treatment.
Some types of infections are linked to only one type of organism, but pneumonia can be caused by bacteria, viruses, or fungi. Regardless of the culprit, though, pneumonia leads to serious respiratory problems by clogging the lungs’ tiny air sacs, called alveoli, with puss or fluid.
When the alveoli don’t work properly, there is an impaired exchange of oxygen and carbon dioxide, leading to decreased levels of oxygen throughout the body. It’s also why people with pneumonia have difficulty breathing.
Signs and symptoms of pneumonia
Common signs and symptoms of pneumonia that mean it’s time to see a doctor include:
• Coughing, which often is productive and produces phlegm
• Chest pain when breathing in or coughing
• Difficulty breathing or shortness of breath
• Fever (102+ degrees) and chills
• Altered mental status or behavior
Although people over 65 or under two years old and those with a weakened immune system are most at risk, pneumonia can hit anyone. Just recently, the sports world was shocked at the death of 34-year-old ESPN reporter Ed Aschoff, a healthy man who died from bacterial pneumonia in both of his lungs.
Because many of the signs and symptoms of pneumonia are consistent with other medical conditions, it’s important for a physician to do a thorough workup.
To evaluate a patient for potential pneumonia, physicians should start with taking a detailed patient history and physical exam.
During the patient history process, nurses and physicians ask questions to find out why the patient came to the office or hospital to be seen, plus recent illnesses, signs, symptoms, medications, and lifestyle habits, including things like smoking.
For the physical exam portion, the doctor should use a stethoscope to listen to chest sounds. Doctors look for abnormal sounds during respiration like crackling or wheezing, as well as for the absence of chest sounds around the chest.
If the physician believes that it’s possible that the patient has pneumonia, the standard of care requires working up the differential diagnosis list through diagnostic testing. Common tests include:
• A chest x-ray or CT scan
• Pulse oximetry, a non-invasive test to measure oxygen saturation
• Lab work to test saliva or mucus
Sometimes primary care providers refer patients to a lung specialist, called a pulmonologist, for a bronchoscopy. This is a procedure where the physician runs a thin flexible tube through the patient’s nose or throat into the lungs.
In my experience, some doctors miss the diagnosis of pneumonia and discharge the patient with an incorrect diagnosis of something else, like a common cold, respiratory infection, or bronchitis. I believe the reason that pneumonia is frequently misdiagnosed is that physicians sometimes skip the important patient safety steps required of the differential diagnosis process.
The only way to safely handle a patient with signs and symptoms consistent with pneumonia is for the doctor to make a complete list of every possible condition that could be the cause. Then, using information from the patient history and physical exam, as well as diagnostic tests, the doctor must rule out each potential cause, starting with the most dangerous one.
To skip any step in the differential diagnosis process needlessly subjects patients to an increased risk of injury or even death. When there’s a delay of diagnosing pneumonia, it’s harder to treat.
If you’ve been seriously injured because of pneumonia misdiagnosis, then contact a top-rated experienced Houston, Texas medical malpractice lawyer for help in evaluating your potential case.