[Survey of diagnostic methods used in the management of pneumonia]

Routine examinations done in patients with pneumonia are following: chest radiograph, Gram stain and culture of sputum. For patients who require hospitalization two sets of blood culture should also be performed. Gram stain and culture of pleural fluid are advised in patients with pleural effusion. Serological testing is important in the diagnosis of atypical pneumonia, but they usually provide retrospective information useful mainly in epidemiological studies. Less frequently used methods are following: bacterial antigen-detection and molecular biology techniques, which may be applied to sputum samples and other biological specimens (pleural fluid, blood, urine etc.). Invasive diagnostic techniques (bronchoalveolar lavage (BAL), protected specimen brush (PSB) or transtracheal aspiration (TTA)) are performed mainly in patients with nosocomial pneumonia especially in critically ill ones. For intubated and mechanically ventilated patients those methods are used to confirm the diagnosis of pneumonia, but for other nosocomial patients the aim is to find causative organism. In spite of higher efficiency of invasive techniques (comparing to non-invasive), one should remember that they may cause dangerous complications and thus before applying them it is necessary to consider if potential benefits overweight risk.