Differential diagnosis of shortness of breath with fever and malaise (pneumonia)
| Subjective assessment | Objective examination |
|---|---|
| History of: | Increasing dyspnoea |
| Predisposing factors, such as influenza, smoking, suppressed cough reflex (for example, coma), pulmonary oedema, COPD, alcoholism, immunosuppression, long term administration of broad range antibiotics, general debility or immobility | Dry cough becoming productive (green purulent sputum) Fever Pleuritic chest pain (worse on inspiration, possibly positional, may be severe) Consolidation: Reduced chest wall expansion on side of consolidation |
| Contact with person with pneumonia or recent hospital admission (less than two weeks previously) | Dull to percussion over affected area Increased TVF and vocal resonance over affected area |
| Increasing breathlessness | Crackles over affected area |
| Upper/lower respiratory tract infection | Wheeze |
| General malaise | Pleuritic rub |
| There may be evidence of failure to cope with normal activities of daily living |