Unformatted text preview: often thought to point to “atypicals” rather than the pneumococcus but prospective studies have not supported this notion. The value of sputum gram-stain (looking for PMNs – to suggest bacterial pneumonia and for characteristic microorganisms) and culture are controversial. Only about 1/3 of patients produce useful sputum and organisms colonizing the mouth but not present in the lung (including the pneumococcus) can confound the interpretation. Blood cultures are also of controversial value because they are positive in only about 10% of patients and usually reveal the pneumococcus (which would be suspected anyway). Nevertheless, these tests are probably useful in sicker patients (fever, elevated WBC) who have not taken antibiotics. Other types of tests that can be useful are shown on the slide titled Additional Test for Cause....
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- Fall '10
- Anatomy, pleuritic chest pain, Pneumocystis carinii, somewhat similar symptoms