how to diagnose and differentiate hospital-acquired pneumonia in the elderly
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Differentiation of nosocomial pneumonia in the elderly
1. Heart failure
In the early stage of left heart failure, there is a cough, foamy sputum, significant difficulty in breathing, inability to lie down, and rales in both lungs are more extensive, and can vary with body position.
2. Lung cancer with obstructive pneumonia
When the effect of adequate antibiotic treatment is not satisfactory or the nature of the shadow in the lung is unknown, examinations such as sputum exfoliated cells, carcinoembryonic antigen, X-ray tomography, CT, and fiberoptic bronchoscopy should be performed to help the diagnosis.
Elderly pulmonary tuberculosis often lacks the typical symptoms, signs and X-ray manifestations. For those with unknown causes of fever, obvious shadows on X-rays, and poor general anti-infective effects, the possibility of pulmonary tuberculosis should be considered. Careful tracing of the medical history, the presence of old tuberculosis foci on X-ray films and examination of sputum acid-fast bacilli are helpful for diagnosis.
4. Pulmonary embolism
He has a history of surgery, trauma, heart disease (especially those with atrial fibrillation) and arteriophlebitis, manifested as sudden dyspnea, cough, hemoptysis, and chest pain. Typical changes in the electrocardiogram help to identify.
Patients with gastrointestinal symptoms should be differentiated from acute gastroenteritis and acute abdomen; shock-type pneumonia should be differentiated from cerebrovascular accidents and their causes.
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