Der Pneumologe

, Volume 2, Issue 1, pp 8–16 | Cite as

Ambulant erworbene Pneumonie

Wie viel Diagnostik muss sein?
Leitthema
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Zusammenfassung

Eine rationale Diagnostik der ambulant erworbenen Pneumonie soll dem Arzt helfen, eine definitive Diagnose zu stellen, den verantwortlichen Erreger zu bestimmen und eine Aussage über die Prognose zu treffen. „Gold-Standard“ in der Diagnosestellung ist neben anamnestischen und klinischen Befunden weiterhin die Röntgenaufnahme der Thoraxorgane. Moderne Entzündungsmarker wie das C-reaktive Protein und in Zukunft möglicherweise das Prokalzitonin sind wichtig für die Differenzialdiagnose und Verlaufsuntersuchung. Die mögliche Erregerdiagnostik umfasst neben der klassischen Kultur neuere Urinantigentests gegen Streptococcus pneumoniae und Legionella pneumophila. Ein einfacher klinischer Prognosescore hilft dem Arzt bei der Entscheidung, welcher Patient ins Krankenhaus eingewiesen werden sollte.

Schlüsselwörter

Ambulant erworbene Pneumonie Erregerdiagnostik Prokalzitonin Legionellen-Urinantigen Prognosescore 

Community-acquired pneumonia

How much diagnostic work-up is necessary?

Abstract

Diagnostic tools are essential for the physician to reach a correct diagnosis of community-acquired pneumonia, to determine the pathogen, and to estimate the prognosis of individual patients. X-ray of the chest remains the “gold standard” for identification of pneumonia. Modern inflammatory markers such as C-reactive protein and in the future procalcitonin are essential for the differential diagnosis and follow-up. The microbiology tests include, besides classic bacterial cultures, urinary antigen tests for Streptococcus pneumoniae and Legionella pneumophila. A simple prognostic score has been developed to help the physician to decide if the patient needs hospitalization.

Keywords

Community-acquired pneumonia Microbiology Procalcitonin Legionella urinary antigen Prognostic score 
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Notes

Interessenkonflikt:

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Copyright information

© Springer Medizin Verlag 2004

Authors and Affiliations

  1. 1.Medizinische Klinik IIIUniversitätsklinikum Schleswig-Holstein, Campus Lübeck
  2. 2.Medizinische Klinik IIIUniversitätsklinikum Schleswig-Holstein (UKSH), Campus LübeckLübeck

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