Community-acquired pneumonia

Global core

Community-acquired pneumonia is an acute infection of the lung parenchyma, usually with cough, fever, and a new focal finding or infiltrate. Severity decides whether the patient stays at home, on a ward, or in intensive care. The antibiotic must match local organisms and resistance. A regimen copied from another country is not assumed to be correct.

What stays the same

• Focal chest signs with fever and cough are pneumonia until a better diagnosis fits.
• Confusion, a high respiratory rate, a low blood pressure, and older age raise the risk.
• The organism and the resistance pattern are local.

1. Recognize. Fever, productive cough, pleuritic pain, and focal crackles or bronchial breathing.
2. Reason. Confusion, low blood pressure, a fast respiratory rate, and age change the risk of death.
3. Prioritize. Hypoxia and shock are treated before the organism is named.
4. Act safely. Oxygen if hypoxic, severity score, and a local first-line antimicrobial. Reassess if there is no improvement.

Local adaptation

No sourced local note is attached to this topic. That is not a statement that every country manages it the same way. The shared principle above is what this beta is willing to teach.

Exam lens

Who is admitted, and which clue suggests a different diagnosis such as embolism or heart failure.