Pulmonary edema etiology

Because the initial bronchitis following respiratory exposure is not infectious, patients will not benefit from administration of antibiotics. However, routine laboratory evaluation shonld include daily sputum cultures. Within the first several days after exposure, patients may develop a chemical pnenmonitis, reflected by fever, elevated white blood cell connts and pulmonary infiltrates, bnt this pnenmonitis is typically sterile. An infectious etiology is uncommon until the third or fourth day after exposure. Patients should receive antibiotics only after identification of a causative organism, not prophylactically (8,25,26). Patients with pnlmonary edema should not receive diuretics, because vesicant-caused pulmonary edema is not cardiogenic (3). 

Pulmonary Edema of Unknown Origin. As indicated in Table 2, there are also several clinically distinct forms of pulmonary edema in which the etiology is unknown. These are discussed in some detail below. 

A careful history and physical examination are key components in the diagnosis of decompensated heart failure. The history should focus on the potential etiologies of heart failure the presence of any precipitating factors onset, duration, and severity of symptoms and a careful medication history. Important elements of the physical examination include vital signs, cardiac auscultation for heart sounds and murmurs, pulmonary examination for the presence of rales, the presence of peripheral edema, and weight. The JVP is a reliable indicator of the patient s volume status and should be evaluated carefully on admission and followed closely as an indicator of the efficacy of diuretic therapy. 

---