| Summary: | Lower respiratory tract infections continue to be among the most common
illnesses requiring medical attention with considerable morbidity and morality. Clinical features, including
underlying conditions, presenting signs and symptoms, basic laboratory investigations and chest
roentgenograms, are not sufficiently precise to infer an etiological agent. These investigations do permit an
assessment of severity of illness and can assist in stratification of patients into high risk groups. Properly
performed and interpreted Gram stain of sputum is still useful in the initial assessment of these patients,
but sputum cultures are less helpful. Blood cultures should be drawn in patients ill enough to require
hospitalization, but the yield is low, Pneumococcal antigen testing and serological studies do not add to
the routine management of patients with pneumonia. In patients with nosocomial pneumonia, the diagnosis
will be established by a synthesis of clinical, roentgenographic and simple laboratory results such as
sputum analysis and blood culture. Invasive investigations should be reserved for critically ill patients.
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