Requirement
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Findings
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At least one of the following
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Altered mental status without any other recognized reason in age≥ 70
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Leukopenia (<4000 WBC/mm3) or leukocytosis(>12000 WBC/mm3)
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Fever(>38°C) without any other reason
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At least two of the following
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New onset or worsening cough, dyspnea, or tachypnea (respiratory rate>25/min)
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New onset of purulent, change in character of sputum over a 24-h period, increase respiratory secretions, or increase suctioning requirements
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Rales, crackles, or bronchial breath sounds
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Worsening gas exchange (e.g., O₂/FIO₂≤240), increased oxygen requirements)
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And ≥2 serial chest radiographs with at least one of the following
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New or progressive and persistent infiltrate, consolidation, or cavitation
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In patients without underlying pulmonary or cardiac disease, one definitive chest radiograph is acceptable
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