[Physical examination of the lungs in suspected pneumonia].

Ned Tijdschr Geneeskd

Leids Universitair Medisch Centrum, afd. Public Health en Eerstelijnsgeneeskunde, Leiden, the Netherlands.

Published: August 2011

Physical examination of the lungs is easy to perform, but the interobserver agreement is poor due to lack of standardisation in the findings. The use of an electronic stethoscope with computerised analysis of the lung sounds might improve diagnostic accuracy. General signs such as fever and an accelerated respiratory and pulse rate increase the probability of a pneumonia. Percussion dullness increases the probability of pneumonia, but its absence does not exclude a pneumonia. Bronchial or decreased breath sounds or crackles increase the probability of pneumonia, but their absence does not exclude a pneumonia. There are no physical diagnostic findings that have a very high predictive value for a pneumonia; all findings should therefore be combined.

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