Investigations
Investigations include: (1)
- chest X-ray
- white cell count is normal or mild leucocytosis - with increase in early granulocyte forms; rarely above 15 x 10^9/l.
- hyponatraemia and hypoalbuminaemia in up to 50%
- abnormal LFT's
- gram stain does not detect the organism
- urine testing may reveal haematuria
Diagnosis is confirmed by:
- urinary antigen detection
- change in antibody titre, with a four fold increase at 2 to 5 weeks
- immuno-flourescent staining of the organism in the pleural fluid, sputum or bronchial washings
- Annotated BTS Guideline for the management of CAP in adults. British Thoracic Society (2009 - Summary of recommendations updated 2015)
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