The evaluation of someone with bacterial pneumonia begins with a history and physical examination.

Physical findings in someone with bacterial pneumonia may include:

• Signs of severe difficulty breathing
• Rib retractions
• Nasal flaring
• Use of accessory muscles
• Cyanosis
• Lips or nailbeds turn blue
• Dry skin
• Dry mouth
• Decreased urination
• Fever
• Rapid pulse
• Rapid breathing
• Wet rales and rhonchi:
• Sounds in the chest during examination with a stethoscope
• Wheezing

Tests are necessary to confirm the diagnosis of bacterial pneumonia and determine its severity.

Tests that may be used to evaluate bacterial pneumonia include:

• Complete blood count:
• C-reactive protein level:
• Can help to identify bacterial pneumonia
• Chest x-ray:
• Normal chest x-ray
• Chest x-ray showing pneumonia
• Pulse oximetry
• Measures the oxygen level in the bloodstream
• Blood cultures
• Bronchoscopy:
• Using a flexible fiberoptic scope to look at the air passageways
• Used to obtain fluid or tissue, in order to test for bacteria
• Sputum culture:
• Used to identify the type of bacteria causing the infection
• Chest CT scan
• Rapid influenza testing:
• Exclude underlying viral infection
• Urine antigen testing for pneumococcus or Legionella