History

Although a confident diagnosis of pneumonia cannot be made on the basis of history alone, it is unlikely that the patient with none of the following symptoms will have pneumonia:

• Fever
• Productive cough
• Sweating
• Shivering
• Myalgia
• Dyspnoea
• Pleuritic chest pain

The history should also identify factors which may influence the management plan if a diagnosis of pneumonia is made. These would include the following:

• Prior or current antibiotic use
• Allergies
• Current medications
• Known respiratory disease e.g. COPD
• Co-morbidities (e.g. congestive cardiac failure, chronic renal failure)
• Immunosuppression (through disease, or medication)
• Social circumstances
• Smoker
• Age >50 years
• New confusion reported by friend, relative or carer