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A 31-year-old female asked:

If an x-ray state infiltrate, is the diagnosis pneumonia of should a culture and sensitivity be ordered? could the infiltrate be something other like edema, blood clot and etc. so getting a sensitivity and culture be the thing to do? infiltrate= need cult

3 doctor answers4 doctors weighed in
Dr. Alan Ertle
Internal Medicine 47 years experience
An : An infiltrate on chest x-ray can be cause by many, many things. Sometimes it is pneumonia, sometimes it is not. Often patients after surgery have an infiltrate on chest x-ray which indicates they are just not breathing deeply. Sometimes tumors can cause infiltrates. There are almost too many things to mention that can cause infiltrates. It is very important to see a pulmonary physician. A culture is important when there are symptoms of pneumonia with fever and chills in the face of a pulmonary infiltrate. One must remember that these must be done before antibiotics are given, but even when that is done correctly, the yield is often not very good. There are a variety of other tests that may be important to diagnose the cause of an infiltrate. However, sometimes tincture of time and a repeat chest x-ray may be all that is indicated.
Dr. J Roberts
Vascular Surgery 28 years experience
Absolutely: The definition of pneumonia: leukocytosis (elevated white blood cell count), fever (> 101), sputum culture + and an infiltrate on cxr (pa/lateral). All four data are required to confirm the DX of pneumonia. Pulmonary edema shows "bat winging" and pulmonary embolism may show "hampton's hump, " but typically reveals nothing on cxr. One needs to order a spiral ct chest to r/o pe.
Dr. John Leander Po
Infectious Disease 19 years experience
Clinical dx: The DX of a pneumonia (pna) is based on clinical findings, confirmed by several lab findings which may also include a culture of sputum. In the community, most docs don't obtain a culture and will immediately treat with antibiotics (abx). A pna developing in the healthcare setting may be resistant to certain abx , so a culture should be obtained. A cxr alone is not sufficient to DX a pna.
Last updated Oct 3, 2016


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