Diagnosing pneumonia

Diagnosing pneumonia

When should you see a doctor?

If cold and flu symptoms do not clear up within the expected timeframe, and appear to worsen, it is best to consult your doctor as soon as possible. Although not all cases of pneumonia need to be treated in hospital, the infection must be diagnosed and treated by a medical professional as soon as possible.

Signs that require immediate medical assistance include:

  • A crushing or squeezing chest pain that increases in intensity, especially when you cough.
  • Trouble breathing – this can be shallow, fast-paced breathing, shortness of breath or wheezing.
  • Coughing up large amounts of blood or rust-coloured mucus. You will also need to see your doctor as soon as possible if your cough frequently brings up yellow or green mucus from the lungs for more than 2 days, occurs with a high fever, vomit frequently or persists for longer than 4 weeks.
  • Dizziness and feeling faint, particularly when sitting up or standing

Diagnosis and tests

Your doctor will assess your symptoms as well as their severity at your consultation. This assessment will likely include a series of questions:

  • What symptoms are you experiencing and how long ago did they start?
  • Have you been travelling at all recently?
  • Have you been exposed to anyone who has been ill?
  • Do you have any past or current medical concerns or problems?
  • Are you taking any medications?
  • Do you smoke? Have you ever smoked? For how long did you smoke?
  • Have you had any vaccinations or other illnesses recently?

Chest X-ray showing pneumonia infection.Your doctor will then conduct a physical exam to better assess and diagnose your symptoms. Things he or she will look out for include crackling, wheezing orunusual sounds in the chest, particularly when you take a breath.

Your doctor may request a chest X-ray to help determine whether you have an infection in your lungs. A chest X-ray will not likely show your type of pneumonia (for instance, viral or bacterial). This will be determined through blood tests. Blood tests will also be necessary to assess if the infection is in your bloodstream.

Additional tests

Depending on the findings of the initial assessments and tests, your doctor may feel it necessary for the following additional tests to diagnose your illness:

  • A CT scan: Similar to an X-ray, the scan will provide a more precise picture which is highly detailed.
  • A sputum test: Mucus that is coughed up is examined to determine the type of pneumonia.
  • Fluid samples: Your doctor will take a fluid sample to determine whether an infection is viral or bacterial if it is noted that there is fluid in the pleural space (the space between the inside of your chest cavity and the tissue covering the outside of your lungs). 
  • A pulse oximetry test: A small sensor is attached to the tip of your fingerand measures the level of oxygen blood saturation. Pneumonia normally prevents normal oxygenation of the blood.
  • A bronchoscopy: If a course of antibiotics fail to treat your pneumonia, your doctor may suggest a bronchoscopy to see the airways inside your lungs and determine whether or not any blockages are inhibiting treatment of your pneumonia.
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