CRITiCAL REVIEW Bacterial Pneumonia or Pulmonary lnfarction?*

T he “textbook” pictures of bacterial pneumonia and pulmonary infarction differ sufficiently to permit accurate diagnosis. Unfortunately, these “textbook” pictures often are absent, particularly in patients with pulmonary infarction. Differentiation in such cases can be a real challenge, because both maladies may give rise to dyspnea, pleuritic pain, tachypnea, tachycardia, fever, cyanosis, hypotension, cough, hemoptysis, jaundice, leukocytosis, and similar roentgenographic abnormalities. This report emphasizes that bacterial pneumonia and pulmonary infarction frequently mimic each other clinically, indicates that most methods for distinguishing between these illnesses are unsatisfactory, and underscores the few techniques that are helpful in differentiation.