Community-acquired Pneumonia

Posted by e-Medical PPT
Community-acquired pneumonia (CAP) is defined as an acute infection of the lung parenchyma accompanied by symptoms of acute illness, which is not acquired in hospitals or other long-term care facilities.One of the most common infectious diseases in the world.
12/1,000/year, about 600,000 hospitalization cases per year (in the U.S.).
The 6th leading cause of death in the U.S. (7th in Taiwan).
The most common cause of death due to infectious disease

Pathology
Primarily involve the interstitium or the alveoli.
Lobar pneumonia
bronchopneumonia
Necrotizing pneumonia
Lung abscess

Clinical Manifestations
Typical presentation
Cough (>90%)
Sudden onset of fever (80%)
SOB (66%)
Sputum production (66%)
Pleuritic pain (50%)
Signs of pulmonary consolidation (dullness, increased fremitus, egophony, bronchial breatathing sound, rales)

Atypical presentation
More gradual onset
Dry cough
Extrapulmonary symptoms
Legionella-CNS, heart, liver, GI and GU
M.pneumoniae- upper RT, GI, skin
The point that extrapulmonary organ involvement  separate atypical from typical pneumonia cannot be overemphasized!
Prompt and accurate diagnosis of CAP is important, since it is the only acute respiratory tract infection in which delayed  antibiotic treatment has been associated with increased risk of death.


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