The Curbsiders Internal Medicine Podcast #76 Pneumonia Pearls with Dr Robert Centor
Jan 1, 2018
Dr. Robert Centor, a seasoned internal medicine professor, joins Neela Bajandas, an Assistant Professor at Temple University, to tackle the complexities of community-acquired pneumonia. They discuss the fine line between accurate diagnosis and misdiagnosis, the importance of biomarkers like procalcitonin, and the nuances of choosing antibiotics in emergency situations. Listeners will gain insights into evolving treatment guidelines, the impact of clinical tools, and a fresh perspective on the challenges within pneumonia management—all served with a side of humor.
AI Snips
Chapters
Transcript
Episode notes
Validate CAP Diagnoses
- Assume a community-acquired pneumonia (CAP) diagnosis from the ED may be incorrect.
- Verify the diagnosis with further history, exam, and testing before accepting it.
Four-Hour Antibiotic Rule Flaw
- The four-hour antibiotic rule for CAP in hospitals led to increased misdiagnosis rates.
- This push for sensitivity decreased specificity, resulting in many false positives.
Misdiagnosis Examples
- Misdiagnosed CAP cases included non-pulmonary issues like UTIs and constipation.
- This highlights the problem of overdiagnosis due to pressure on ED physicians.