The gold standard for diagnosis of community-acquired pneumonia is the presence of an infiltrate on plain chest x-ray in a patient who presents with signs and symptoms that are clinically suggestive of pneumonia (cough, fever, pleuritic chest pain, dyspnea, sputum, crackles, decreased or bronchial breath sounds on auscultation).

Here are five points to remember when suspecting pneumonia:

1. The presence of an infiltrate on plain chest x-ray is diagnostic.
2. Chest x-ray (PA) and lateral views are adequate.
3. CT scan has higher sensitivity and accuracy than chest x-ray.
4. Volume depletion may produce an initially negative radiograph.
5. X-ray can be normal in the first 24 hours. If you suspect pneumonia, start empiric antibiotics and repeat the chest x-ray in 24 to 48 hours or do a HR CT scan or lung ultrasound.

Dr KK Aggarwal

Padma Shri Awardee

President Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA