Pneumonia is a lung inflammation caused by bacterial or viral infection, in which the air sacs fill with pus and may become solid. Inflammation may affect both lungs (double pneumonia), one lung (single pneumonia), or only certain lobes (lobar pneumonia). Those at highest risk for serious complications are children, the elderly, and immunocompromised adults.
Misdiagnosis of pneumonia will delay treatment and can result in long-term disability or death. Despite the serious potential consequences of misdiagnosis, pneumonia is misdiagnosed at an alarming rate, even among patients who are readmitted to the hospital after suffering from pneumonia in the recent past.
Misdiagnosis of pneumonia is common because the symptoms are similar to many other illnesses that are less serious in nature. Because respiratory illnesses are more common in the winter, and because pneumonia mimics many of those same conditions, an errant pneumonia diagnosis is, even more likely during this time of year. Pneumonia is the second most misdiagnosed condition leading to readmission after a previous hospitalization, second only to congestive heart failure. Blood tests and sputum cultures can be helpful to make the diagnosis of pneumonia. The diagnosis should be confirmed by X-ray, and if pneumonia is not evident, antibiotics should be discontinued and other causes of the patient’s symptoms should be sought. In healthcare clinics outside of the hospital setting, the diagnosis is often made solely on clinical symptoms and a physical examination.
One of the most effective ways to diagnose pneumonia is by chest x-ray. However, a chest x-ray in a person with pneumonia does not always have the characteristic “infiltrate” if it is early in the course of the illness. Sometimes, the infiltrate may be in a portion of the lung that is not easily seen by standard x-ray, and other patients may have congestive heart failure or scarring in their lungs, which can mimic pneumonia. Therefore, it is important to distinguish pneumonia from these other problems because the treatment is very different.
When a doctor diagnoses pneumonia, there are five findings on examination that increase the probability of the diagnosis. These include:
A fever greater than 100 degrees F (37.8 C).
Heart rate greater than 100 beats per minute.
Crackles (rales) heard in the lungs with a stethoscope.
Decreased breath sounds.
No asthma.
If a patient has all five of these findings, they have a high probability of pneumonia, 47% in a primary care setting and 75% in an emergency department setting. If they only have one of these findings, however, the chance that their illness is due to pneumonia is only 1% and 2%, respectively so the doctor should search for other causes of their cough, chest pain, or shortness of breath.
The Thistle Law Firm is experienced in handling cases of the misdiagnosis and failure to appropriately treat pneumonia. If you or a family member suffered harm due to a failure to diagnose or properly treat pneumonia, the attorneys at The Thistle Law Firm are here to take your call and answer your questions at 215-525-6824.