Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- 28 Acute and Chronic Bronchitis
- 29 Croup, Supraglottitis, and Laryngitis
- 30 Atypical Pneumonia
- 31 Community-Acquired Pneumonia
- 32 Nosocomial Pneumonia
- 33 Aspiration Pneumonia
- 34 Lung Abscess
- 35 Empyema and Bronchopleural Fistula
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
31 - Community-Acquired Pneumonia
from Part V - Clinical Syndromes – Respiratory Tract
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- 28 Acute and Chronic Bronchitis
- 29 Croup, Supraglottitis, and Laryngitis
- 30 Atypical Pneumonia
- 31 Community-Acquired Pneumonia
- 32 Nosocomial Pneumonia
- 33 Aspiration Pneumonia
- 34 Lung Abscess
- 35 Empyema and Bronchopleural Fistula
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
Community-acquired pneumonia (CAP) is a significant cause of morbidity and mortality in the United States. Most episodes occur after the sixth decade of life in patients with one or more chronic underlying diseases. Mortality from CAP averages 14% and has not decreased significantly since the early 1950s, despite advances in antibiotic and intensive care therapy.
Making the diagnosis of pneumonia is usually not difficult; deciding which patients should be admitted to the hospital and selecting appropriate therapy, however, can be challenging. The purpose of this chapter is to assist the clinician in deciding which patients should be admitted to the hospital and in selecting antibiotic therapy for CAP in immunocompetent patients who are not residents of chronic care facilities.
DIAGNOSIS AND TREATMENT
The diagnosis of pneumonia is suspected when one or more of the following clinical findings are present: cough, purulent sputum, dyspnea, pleuritic pain, fever, leukocytosis, chest auscultation findings consistent with pneumonia, or a new pulmonary inifiltrate. Once the diagnosis is made, the physician must decide whether hospitalization is necessary and, if hospitalized, whether intensive care unit (ICU) monitoring is advised.
A number of risk factors predict a complicated course (Table 31.1). Two published sets of criteria may assist the physician in deciding if hospitalization is necessary: the CURB-65 score from the British Thoracic Society and the Pneumonia Severity Index (PSI) from the Pneumonia Patient Outcomes Research Team (PORT).
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- Chapter
- Information
- Clinical Infectious Disease , pp. 221 - 228Publisher: Cambridge University PressPrint publication year: 2008