Community-acquired pneumonia is defined as the infection of lung parenchyma which is not acquired in the hospital, long-term care facility, or another recent contact with health care system. It causes significant morbidity and mortality in adults.
Community-acquired Pneumonia is caused by:-
Symptoms of Pneumonia:-
Increased yellowish sputum production
Chest pain which is more of deep inspiration
Altered mental state( particularly in old age)
Hypotension (low blood pressure)
Investigations Recommended for Pneumonia :
Complete blood count
Kidney function test
Liver function test
Sputum examination for gram stain, AFB Stain, culture sensitivity
Blood culture and sensitivity
Treatment for Pneumonia:-
The decision regarding inpatient versus outpatient treatment is based on CURB 65 criteria. There are 5 variables in this scoring system (each variable is given one point if the total score is two or more than patient should be admitted and treated if the score is three or more than ICU admission is advised).
Blood urea nitrogen level>20mg/dl
Respiratory rate > 30 breaths per minute
Blood pressure (Systolic<90mm of Hg or diastolic <60mm of Hg
Age more than 65 years
If the patient has no comorbidities then outpatient treatment should be with macrolides or doxycycline.
If the patient has comorbidities and/or antibiotic use within last three months then outpatient treatment should be with beta-lactam antibiotics plus macrolides or respiratory quinolones should be used as monotherapy.
In non ICU inpatients treatment should include beta-lactam antibiotics plus macrolide or respiratory quinolone(levofloxacin)
In Icu patients beta-lactam antibiotics plus IV, Azithromycin/respiratory quinolones should be used
If there is a risk factor for pseudomonas antipseudomonal antibiotic should be added, if there is a risk factor for MRSA Vancomycin or linezolid should be added.
If there is a suspicion of swine flu oseltamivir should be added.
Complications associated with Pneumonia:-
Indication for CT SCAN chest:-
Pneumonia not improving after 48-72 hours of therapy