Table 3. Clinical Indications for More Extensive Diagnostic Testing Indication
Blood Intensive care unit admission
Failure of outpatient antibiotic therapy Cavitary infiltrates Leukopenia
Active alcohol abuse Chronic severe liver disease
Severe obstructive/structural lung disease Asplenia (anatomic or functional) Recent travel (within past 2 weeks) Positive Legionella UAT result Positive pneumococcal UAT result Pleural effusion
NA, not applicable; UAT, urinary antigen test. a
Culture ✔
✔ ✔ ✔ ✔
✔ ✔
✔ ✔
✔d ✔ ✔
NA ✔
NA ✔
✔e
Endotracheal aspirate if intubated, possibly bronchoscopy or nonbronchoscopic bronchoalveolar lavage. b Fungal and tuberculosis cultures.
c See Table 8 in the "IDSA/ATS Consensus Guidelines on the management of CAP in adults" for details. d Special media for Legionella.
e Thoracentesis and pleural fluid cultures.
Sputum Culture
✔ ✔ ✔
✔ ✔ ✔ ✔c
Legionella UAT
✔ ✔
Pneumococcal UAT
✔ ✔
✔
✔ ✔ ✔
Other ✔a
✔b
