With right lower lobe pneumonia or left lower lobe pneumonia right upper or left upper abdominal pain can be mimicked. The pain perception is similar to atelectases (collapsed lung).
The symptoms vary somewhat depending on the pathogen isolated. However, there is usually a cough, elevated body temperature, production of mucus or phlegm and pain in the affected chest area. The patient may have a piercing pain with coughing or dyspnea. With lower lobe pneumonia there is often so much irritation of the diaphragm that there can be radiating pain into the right or left upper abdomen.
It is because of this radiating pain into the abdomen that pneumonia is mentioned here. Chest X-rays will confirm the diagnosis. Typically, a shadow in the lower lung of the patient is produced from the higher tissue density associated with the lower lobe pneumonia. The physician may find crackling sounds on auscultation.
Sputum that was cultured often is growing bacteria, such as the pathogen Streptococcus pneumoniae. However, with viral pneumonia the cultures may be negative. I am not going into the various possible causes of pneumonia here. Treatment varies regarding the cause of the pneumonia, although often it is a presumptive diagnosis, if there is no positive identification of a pathogen. Empiric antibiotics are often given.
1. DM Thompson: The 46th Annual St. Paul’s Hospital CME Conference for Primary Physicians, Nov. 14-17, 2000, Vancouver/B.C./Canada
2. C Ritenbaugh Curr Oncol Rep 2000 May 2(3): 225-233.
3. PA Totten et al. J Infect Dis 2001 Jan 183(2): 269-276.
4. M Ohkawa et al. Br J Urol 1993 Dec 72(6):918-921.
5. Textbook of Primary Care Medicine, 3rd ed., Copyright © 2001 Mosby, Inc., pages 976-983: “Chapter 107 – Acute Abdomen and Common Surgical Abdominal Problems”.
6. Marx: Rosen’s Emergency Medicine: Concepts and Clinical Practice, 5th ed., Copyright © 2002 Mosby, Inc. , p. 185:”Abdominal pain”.
7. Feldman: Sleisenger & Fordtran’s Gastrointestinal and Liver Disease, 7th ed., Copyright © 2002 Elsevier, p. 71: “Chapter 4 – Abdominal Pain, Including the Acute Abdomen”.
8. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.