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©2013 UpToDate ® Print Email Clinical indications for diagnostic testing for community-acquired pneumonia Indication Blood culture Sputum culture Legionella UAT Pneumococcal UAT Other Intensive care unit admission X X X X X* Failure of outpatient antibiotic therapy X X X Cavitary infiltrates X X X• Leukopenia X X Active alcohol abuse X X X X Chronic severe liver disease X X Severe obstructive/structural lung disease X Asplenia (anatomic or functional) X X Recent travel (within past 2 weeks) X XΔ Positive Legionella UAT result X◊ NA Positive pneumococcal UAT result X X NA Pleural effusion X X X X X§ NA: not applicable; UAT: urinary antigen test. * Endotracheal aspirate if intubated, possibly bronchoscopy or nonbronchoscopic bronchoalveolar lavage. • Fungal and tuberculosis cultures. Δ See "Risk factors pathogens CAP" for details. ◊ Special media for Legionella. See "Dx Legionella". § Thoracentesis and pleural fluid cultures. Reproduced with permission from: Mandell, LA, Wunderink, RG, Anzueto, A, et al. Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults. Clin Infect Dis 2007; 44 (Suppl 2):S27. Copyright ©2007 University of Chicago.