{
  "url": "https://openlegislation.uk/eu-decision-2018-945/annex-II/division-4/division-4.1/division-4.1.10",
  "json_url": "https://openlegislation.uk/eu-decision-2018-945/annex-II/division-4/division-4.1/division-4.1.10.json",
  "legislation": "eudn/2018/945",
  "legislation_title": "Commission Implementing Decision (EU) 2018/945 of 22 June 2018 on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant case definitions (Text with EEA relevance)",
  "legislation_url": "https://openlegislation.uk/eu-decision-2018-945",
  "path": "annex/II/division/4/division/4.1/division/4.1.10",
  "kind": "division",
  "number": "4.1.10",
  "heading": "PN: Pneumonia",
  "text": "Two or more serial chest X-rays or CT-scans with a suggestive image of pneumonia for patients with underlying cardiac or pulmonary disease. In patients without underlying cardiac or pulmonary disease one definitive chest X-ray or CT-scan is sufficient\nAND at least one of the following symptoms\nFever > 38 °C with no other cause\nLeukopenia (< 4 000 WBC/mm3) or leucocytosis (≥ 12 000 WBC/mm3)\nAND at least one of the following (or at least two if clinical pneumonia only = PN 4 and PN 5)\nNew onset of purulent sputum, or change in character of sputum (colour, odour, quantity, consistency)\nCough or dyspnea or tachypnea\nSuggestive auscultation (rales or bronchial breath sounds), ronchi, wheezing\nWorsening gas exchange (for example, O2 desaturation or increased oxygen requirements or increased ventilation demand)\nand according to the used diagnostic method\n(a) Bacteriologic diagnostic performed by:\nPositive quantitative culture from minimally contaminated LRT specimen (PN 1)\nBroncho-alveolar lavage (BAL) with a threshold of ≥ 104 CFU/ml or ≥ 5 % of BAL obtained cells contains intracellular bacteria on direct microscopic exam (classified on the diagnostic category BAL)\nProtected brush (PB Wimberley) with a threshold of ≥ 103 CFU/ml\nDistal protected aspirate (DPA) with a threshold of ≥ 103 CFU/ml\nPositive quantitative culture from possibly contaminated LRT specimen (PN 2)\nQuantitative culture of LRT specimen (for example, endotracheal aspirate) with a threshold of 106 CFU/ml\n(b) Alternative microbiology methods (PN 3)\nPositive blood culture not related to another source of infection\nPositive growth in culture of pleural fluid\nPleural or pulmonary abscess with positive needle aspiration\nHistologic pulmonary exam shows evidence of pneumonia\nPositive exams for pneumonia with virus or particular germs (for example, Legionella, Aspergillus, mycobacteria, mycoplasma, Pneumocystis jirovecii):\nPositive detection of viral antigen or antibody from respiratory secretions (for example, EIA, FAMA, shell vial assay, PCR)\nPositive direct exam or positive culture from bronchial secretions or tissue\nSeroconversion (for example, influenza viruses, Legionella, Chlamydia)\nDetection of antigens in urine (Legionella)\n(c) Others\nPositive sputum culture or non-quantitative LRT specimen culture (PN 4)\nNo positive microbiology (PN 5)",
  "extent": "E+W+S+N.I.",
  "status": null,
  "version": "current",
  "annotations": [
    {
      "type": "footnote",
      "label": "f1",
      "text": "LRT = Lower Respiratory Tract"
    },
    {
      "type": "footnote",
      "label": "f2",
      "text": "CFU = Colony Forming Units"
    }
  ],
  "outstanding_effects": [],
  "provenance": {
    "source": "legislation.gov.uk",
    "source_url": "https://www.legislation.gov.uk/eudn/2018/945/annex/II/division/4/division/4.1/division/4.1.10",
    "retrieved_at": "2026-11-01T15:13:03.598650+00:00"
  },
  "licence": "Open Government Licence v3.0",
  "licence_url": "https://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/",
  "attribution": "Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives."
}