Diagnostic gold standards

Confirmation of recently suspected pneumonia can be provided at postmortem when inflammation involves several airspaces and cultures confirm a pathogen. Cultures from pleural fluid or blood, or appropriate serology in the correct clinical setting without evidence of another focus, can be taken as diagnostic, as can new pulmonary cavitation, although these can be misleading. A positive response to antibiotics may be misleading; recovery in the absence of antibiotics is a clearer finding (Meduri 1990).

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