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Symptoms, Medical History Insufficient to Correctly Detect Pneumonia

Update Date: Jan 24, 2013 03:26 AM EST

It might not be possible for a doctor to correctly detect pneumonia based only on the symptoms and the patient's medical history, says a study. Pneumonia is a respiratory disease where there is an inflammation in the lung affecting the alveoli, the microscopic air sacs. The common symptoms are cough, chest pain, fever and breathing problems.

The research was led by Saskia van Vugt from the Utrecht Julius Center for Health Sciences and Primary Care in the Netherlands, and the research details were published online in the European Respiratory Journal.

Majority of doctors base the diagnosis of pneumonia on the symptoms and the patient's medical history and do not suggest a chest radiograph. But not doing so, they are unable to detect whether the patient is suffering from pneumonia or acute bronchitis as the latter is more common than the former.

In order to follow the correct treatment path and to avoid administration of wrong medication, it is essential for a doctor to correctly diagnose whether a patient is suffering from pneumonia or acute bronchitis. Pneumonia requires excessive antibiotic treatment while acute bronchitis does not need it. Therefore, to ensure correct treatment, a chest X-ray is important.

The study analyzed the data of 2,810 patients across 12 European countries, all of whom had severe cough and their doctors were asked to find out whether the patients had pneumonia based on the external symptoms. Their verdict was noted and then a chest X-ray was performed on all of these patients.

After the X-rays it was found that 140 patients were really suffering from pneumonia and 29 percent of the doctors of these patients were able to diagnose it correctly. About one percent, which was 31 patients, was those where the doctor diagnosed pneumonia but the chest radiograph showed otherwise.

For those patients where the doctors had said the symptoms were not of pneumonia, 96 percent turned out to be correct. So it was concluded that while the doctors were accurately able to count out pneumonia, they were not so successful in diagnosing the disease in those whose chest X- rays confirmed pneumonia

"The results of the study are encouraging to some extent as the findings might support physicians to rely more on their ability to correctly exclude pneumonia which might result in better targeted antibiotic prescriptions. However, a majority of the pneumonia cases in this study was not picked up by an initial assessment alone. Tests that could support a doctor's ability to detect or exclude pneumonia are urgently needed. We should also remember that GPs tell patients to revisit them if symptoms get worse or persist, as a 'safety net' for initially missed cases," Saskia van Vugt was quoted in Medicalxpress.

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