Category Archives: Diagnosis

EUH Dressler Conference: What is the epidemiology of legionella pneumonia?

The Bottom Line: Legionella pneumonia accounts for 2-7% of community-acquired pneumonia (CAP) worldwide. In the U.S., legionella infections accounted for 1.3 per 100,000 cases between 2011-2013. Of the 1,426 cases reported in the U.S between 2011-2013: 79% in patients > 50 … Continue reading

Posted in Background question, Diagnosis, EUH

EUH Dressler Conference: What is the sensitivity/specificity of the legionella urine antigen test?

The Bottom Line: The sensitivity and specificity of the Legionella urine antigen test are as high as 90% and 99%, respectively. The test for Legionella pneumophila detects only serogroup 1, but this serogroup accounts for most community-acquired cases of Legionnaires’ disease in the United States … Continue reading

Posted in Diagnosis, EUH

EUH Krakow Conference: What are the differential diagnoses for a pleural effusion with low pleural fluid glucose?

The Bottom Line: Low pleural fluid glucose (<60 mg/dL) indicates the pleural effusion is most likely caused by one of the following: Empyema Complicated parapneumonic effusion Malignant pleural effusion Tuberculous pleural effusion Rheumatoid pleural effusion Other rare causes of low … Continue reading

Posted in Diagnosis, EUH

EUH Morning Report: Does my patient have hepatomegaly?

The Bottom Line: Hepatomegaly should be considered for patients with known or suspected liver disorders, malignancy, or congestive heart failure. When there is a suspicion of liver disease, it’s recommended that clinicians forgo the scratch test and use percussion to … Continue reading

Posted in Diagnosis, EUH

EUH Dressler Conference: What is the clinical exam for pericardial tamponade?

The Bottom Line: Among patients with cardiac tamponade, a minority will not have dyspnea, tachycardia, elevated jugular venous pressure, or cardiomegaly on chest radiograph. A pulsus paradoxus greater than 10 mm Hg among patients with a pericardial effusion helps distinguish those … Continue reading

Posted in Diagnosis, EUH

EUH Morning Report: Delayed paracentesis and mortality risk with spontaneous bacterial peritonitis

The Bottom Line: In a study of hospitalized patients with spontaneous bacterial peritonitis (SBP), Kim et al (2014) concluded: Patients who receive delayed paracentesis (DP) had a higher in-hospital mortality (27% vs 13%) compared with those who received early paracentesis (EP). … Continue reading

Posted in Diagnosis, EUH, Therapy

EUH Morning Report: Diagnosing ascites

The Bottom Line: Three guidelines are most useful when determining if a patient has ascites (Williams and Simel, 1992, p.2648): The most useful findings for ruling out ascites are negative histories of ankle swelling or increased abdominal girth, and the inability  … Continue reading

Posted in Diagnosis, EUH