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74: PNEUMONIA

Eric Shamus, PhD, DPT, PT, CSCS; Jennifer Shamus, PhD, DPT, COMT, CSCS

CONDITION/DISORDER SYNONYMS

  • Acute interstitial pneumonia

  • Bronchial pneumonia

  • Lobar pneumonia

  • Lung inflammation

  • Pneumonitis

ICD-9-CM CODES

  • 480 Viral pneumonia

  • 481 Pneumococcal pneumonia [streptococcus pneumoniae pneumonia

  • 482 Other bacterial pneumonia

  • 483 Pneumonia due to other specified organism

  • 484 Pneumonia in infectious diseases classified elsewhere

  • 485 Bronchopneumonia, organism unspecified

  • 486 Pneumonia, organism unspecified

  • Associated physical therapy diagnoses/treatment diagnosis

    • 780.7 Malaise and fatigue

    • 786.0 Dyspnea and respiratory abnormalities

    • 786.05 Shortness of breath

ICD-10-CM CODES

  • J12.0 Adenoviral pneumonia

  • J12.1 Respiratory syncytial virus pneumonia

  • J12.2 Parainfluenza virus pneumonia

  • J12.81 Pneumonia due to SARS-associated coronavirus

  • J12.89 Other viral pneumonia

  • J12.9 Viral pneumonia, unspecified

  • J13 Pneumonia due to Streptococcus pneumoniae

  • J15.0 Pneumonia due to Klebsiella pneumoniae

  • J18.1 Lobar pneumonia, unspecified organism

PREFERRED PRACTICE PATTERNS1

  • 6C: Impaired Ventilation, Respiration/Gas Exchange, and Aerobic Capacity/Endurance Associated with Airway Clearance Dysfunction

  • 6F: Impaired Ventilation and Respiration/Gas Exchange Associated with Respiratory Failure

PATIENT PRESENTATION

A 61-year-old woman presents to the emergency room complaining of cough for 2 weeks. The cough is productive of green sputum and is associated with sweating, shaking chills, and fever up to 102°F (38.8°C). She was exposed to her grandchildren who were told that they had upper respiratory infections 2 weeks ago but now are fine. Her past medical history is significant for diabetes for 10 years, which is under good control using oral hypoglycemics. She denies tobacco, alcohol, or drug use. On examination, she looks ill and in distress, with continuous coughing and chills. Her blood pressure is 100/80 mm Hg, her pulse is 110 beats/min, her temperature is 101°F (38.3°C), her respirations are 24 breaths/min, and her oxygen saturation is 97% on room air. Examination of the head and neck is unremarkable. Her lungs have rhonchi and decreased breath sounds, with dullness to percussion in bilateral bases. Her heart is tachycardic but regular. Her extremities are without signs of cyanosis or edema. The remainder of her examination is normal. A complete blood count (CBC) shows a high white blood cell (WBC) count of 17,000 cells/mm3, with a differential of 85% neutrophils and 20% lymphocytes. Her blood sugar is 120 mg/dL.2

FIGURE 74-1

Right lower lobe pneumonia—subtle opacity on PA film (red arrow), while the lateral film illustrates the “spine sign” (black arrow) where the lower spine does not become more lucent. (From Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison’s Principles of Internal Medicine. 18th ed. New York, NY: McGraw-Hill; 2012.)

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KEY FEATURES

Description

  • Inflammation of the lungs (specifically the alveoli)

  • Infection can be bacterial, viral, fungal, or parasitic

  • Pneumonitis is lung inflammation

  • Pneumonia is pneumonitis with pulmonary consolidation

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