Community-acquired pneumonia - Revision history

Aidan: /* Investigations */

2026-03-27T14:14:35Z

Investigations

← Older revision		Revision as of 14:14, 27 March 2026
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	* Always add ''[[Legionella]]'' testing in immunocompromised, critical illness, recent travel, significant alcohol, and consider when pleural effusion is present		* Always add ''[[Legionella]]'' testing in immunocompromised, critical illness, recent travel, significant alcohol, and consider when pleural effusion is present
			* Chest x-ray
			** Still abnormal at 6 weeks in about 25% of patients

	== Further Reading ==		== Further Reading ==

Aidan at 17:30, 19 September 2024

2024-09-19T17:30:07Z

← Older revision		Revision as of 17:30, 19 September 2024
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	=== Microbiology ===		=== Microbiology ===

			* Bacteria (15-30%)[[CiteRef::gadsby2022th]]
	* Bacteria (15-30%)<ref>Gadsby NJ, Musher DM. The Microbial Etiology of Community-Acquired Pneumonia in Adults: from Classical Bacteriology to Host Transcriptional Signatures. ''Clin Microbiol Rev''. 2022 Sep 27:e0001522. doi: [https://doi.org/10.1128/cmr.00015-22 10.1128/cmr.00015-22]. Epub ahead of print. PMID: [https://pubmed.ncbi.nlm.nih.gov/36165783/ 36165783].</ref>
	** Typical organisms		** Typical organisms
	*** [[Streptococcus pneumoniae]] (5-15%)		*** [[Streptococcus pneumoniae]] (5-15%)

Aidan: /* Microbiology */

2022-10-04T02:17:36Z

Microbiology

← Older revision		Revision as of 02:17, 4 October 2022
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	=== Microbiology ===		=== Microbiology ===

			* Bacteria (15-30%)<ref>Gadsby NJ, Musher DM. The Microbial Etiology of Community-Acquired Pneumonia in Adults: from Classical Bacteriology to Host Transcriptional Signatures. ''Clin Microbiol Rev''. 2022 Sep 27:e0001522. doi: [https://doi.org/10.1128/cmr.00015-22 10.1128/cmr.00015-22]. Epub ahead of print. PMID: [https://pubmed.ncbi.nlm.nih.gov/36165783/ 36165783].</ref>
	* Bacteria
	** Typical organisms		** Typical organisms
	*** ''[[Streptococcus pneumoniae]]''		*** [[Streptococcus pneumoniae]] (5-15%)
	*** ''[[Haemophilus influenzae]]''		*** [[Haemophilus influenzae]] (1-7%)
	*** ''[[Staphylococcus aureus]]''		*** [[Staphylococcus aureus]] (2-5%)
	*** Group A ~~streptococci~~		*** [[Group A streptococcus]]
	*** ''[[Moraxella catarrhalis]]''		*** [[Moraxella catarrhalis]]
	*** Anaerobes and aerobic gram-negative bacteria		*** Anaerobes and aerobic gram-negative bacteria
	**** ''[[Klebsiella pneumonia]]''		**** [[Klebsiella pneumonia]]
	**** ''[[Pseudomonas aeruginosa]]''		**** [[Pseudomonas aeruginosa]] (1-3%)
	**** ''[[Acinetobacter baumannii]]''		**** [[Acinetobacter baumannii]]
	** Atypical organisms		** Atypical organisms
	*** ''[[Legionella]]'' ~~spp.~~		*** [[Legionella]] species (1-6%)
	*** ''[[Mycoplasma pneumoniae]]''		*** [[Mycoplasma pneumoniae]] (1-10%)
	*** ''[[Chlamydia pneumoniae]]''		*** [[Chlamydia pneumoniae]] (1-3%)
	*** ''[[Chlamydia psittaci]]''		*** [[Chlamydia psittaci]]
	** Others		** Others
	*** ''[[Coxiella burnetti]]''		*** [[Coxiella burnetti]]
			*** [[Nocardia]]
	* Viral
	** [[~~Influenza virus~~]]		*** [[Mycobacteria]]
			* Viruses (25-60%)
	** [[Parainfluenza virus]]
	** [[~~RSV~~]]		** [[Rhinovirus]] (8-17%)
	** [[~~Adenovirus~~]]		** [[Coronavirus]] (3-13%)
	** [[~~Human~~ ~~metapneumovirus~~]]		** [[Influenza virus]] (1-6%)
			** [[Human metapneumovirus]] (1-8%)
	** [[Middle East respiratory syndrome coronavirus]] (MERS-CoV)
	** [[~~Rhinovirus~~]]		** [[Parainfluenza virus]] (1-8%)
			** [[RSV]] (1-8%)
⚫	* Fungi
	** ''[[~~Cryptococcus~~]]'' ~~spp.~~		** [[Adenovirus]] (1-8%)
		⚫	* Fungi (1-3%)
⚫	** ''[[Histoplasma capsulatum]]''
	** ''[[~~Coccidioides~~]]''		** [[Pneumocystis jirovecii]]
			** [[Cryptococcus]] species
		⚫	** [[Histoplasma capsulatum]]
			** [[Coccidioides]]
			* No cause identified (46-66%)
	* Clinically-important but uncommon organisms		* Clinically-important but uncommon organisms
	** ''[[Legionella]]'' species		** [[Legionella]] species
	** [[Influenza]] A and B, including avian influenza A H5N1 and avian influenza A H7N9		** [[Influenza]] A and B, including avian influenza A H5N1 and avian influenza A H7N9
	** [[MERS-CoV]] and [[severe acute respiratory syndrome coronavirus]] (SARS-CoV)		** [[MERS-CoV]] and [[severe acute respiratory syndrome coronavirus]] (SARS-CoV)

Aidan: /* Background */

2021-11-03T12:35:17Z

Background

← Older revision		Revision as of 12:35, 3 November 2021
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	== Background ==		== Background ==

	* See also [[Respiratory infection in an immunocompromised person]] and [[Respiratory ~~disease~~ in unimmunized hosts]]		* See also [[Respiratory infection in an immunocompromised person]] and [[Respiratory infection in unimmunized hosts]]

	=== Microbiology ===		=== Microbiology ===

Aidan at 12:34, 3 November 2021

2021-11-03T12:34:38Z

← Older revision		Revision as of 12:34, 3 November 2021
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	== ~~Microbiology~~ ==		== Background ==

			* See also [[Respiratory infection in an immunocompromised person]] and [[Respiratory disease in unimmunized hosts]]

			=== Microbiology ===

	* Bacteria		* Bacteria
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	== Investigations ==		== Investigations ==

	* Always add ''Legionella'' testing in immunocompromised, critical illness, recent travel, significant alcohol, and consider when pleural effusion is present		* Always add ''[[Legionella]]'' testing in immunocompromised, critical illness, recent travel, significant alcohol, and consider when pleural effusion is present

	== Management ==

	== Prognosis ==

	== Further Reading ==		== Further Reading ==

Aidan: Text replacement - "Clinical Presentation" to "Clinical Manifestations"

2020-07-20T00:19:18Z

Text replacement - "Clinical Presentation" to "Clinical Manifestations"

← Older revision		Revision as of 00:19, 20 July 2020
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	** Community-associated methicillin-resistant [[Staphylococcus aureus]] (CA-MRSA)		** Community-associated methicillin-resistant [[Staphylococcus aureus]] (CA-MRSA)

	== Clinical ~~Presentation~~ ==		== Clinical Manifestations ==

	* Acute onset cough, dyspnea, and fever		* Acute onset cough, dyspnea, and fever

Aidan: /* Severity */ fixed list formatting

2019-10-03T00:05:52Z

Severity: fixed list formatting

← Older revision		Revision as of 00:05, 3 October 2019
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	* Per IDSA guidelines[[CiteRef::metlay2019di]], severe CAP includes either ''one major'' criterion or ''three or more minor'' criteria		* Per IDSA guidelines[[CiteRef::metlay2019di]], severe CAP includes either ''one major'' criterion or ''three or more minor'' criteria
	* '''Minor criteria'''		* '''Minor criteria'''
	** ~~Respiratory~~ rate ≥ 30 breaths/min		** Respiratory rate ≥ 30 breaths/min
	** ~~PaO2~~/FiO2 ratio ≤ 250		** PaO2/FiO2 ratio ≤ 250
	** ~~Multilobar~~ infiltrates		** Multilobar infiltrates
	** ~~Confusion~~/disorientation		** Confusion/disorientation
	** ~~Uremia~~ (blood urea nitrogen level ≥ 20 mg/dl)		** Uremia (blood urea nitrogen level ≥ 20 mg/dl)
	** ~~Leukopenia~~ not due to chemotherapy (white blood cell count < 4,000 cells/μl)		** Leukopenia not due to chemotherapy (white blood cell count < 4,000 cells/μl)
	** ~~Thrombocytopenia~~ (platelet count < 100,000/μl)		** Thrombocytopenia (platelet count < 100,000/μl)
	** ~~Hypothermia~~ (core temperature < 36°C)		** Hypothermia (core temperature < 36°C)
	** ~~Hypotension~~ requiring aggressive fluid resuscitation		** Hypotension requiring aggressive fluid resuscitation
	* '''Major criteria'''		* '''Major criteria'''
	** ~~Septic~~ shock with need for vasopressors		** Septic shock with need for vasopressors
	** ~~Respiratory~~ failure requiring mechanical ventilation		** Respiratory failure requiring mechanical ventilation

	== Investigations ==		== Investigations ==

Aidan: /* Severity */

2019-10-03T00:05:08Z

Severity

← Older revision		Revision as of 00:05, 3 October 2019
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	* Per IDSA guidelines[[CiteRef::metlay2019di]], severe CAP includes either ''one major'' criterion or ''three or more minor'' criteria		* Per IDSA guidelines[[CiteRef::metlay2019di]], severe CAP includes either ''one major'' criterion or ''three or more minor'' criteria
	* '''Minor criteria'''		* '''Minor criteria'''
	** Respiratory rate ≥ 30 breaths/min		** Respiratory rate ≥ 30 breaths/min
	** PaO2/FiO2 ratio ≤ 250		** PaO2/FiO2 ratio ≤ 250

Aidan: /* Clinical Presentation */ added severity criteria

2019-10-03T00:04:44Z

Clinical Presentation: added severity criteria

@@ Line 39: / Line 39: @@
 == Clinical Presentation ==
-* If effusion, consider ''Legionella''
+* If effusion, consider ''[[Legionella]]''
 == Investigations ==

Aidan: /* Microbiology */ linkified

2019-10-03T00:00:12Z

Microbiology: linkified

← Older revision		Revision as of 00:00, 3 October 2019
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	** [[RSV]]		** [[RSV]]
	** [[Adenovirus]]		** [[Adenovirus]]
	** Human metapneumovirus		** [[Human metapneumovirus]]
	** Middle East respiratory syndrome ~~virus~~ (MERS-CoV)		** [[Middle East respiratory syndrome coronavirus]] (MERS-CoV)
	** Rhinovirus		** [[Rhinovirus]]
	* Fungi		* Fungi
	** ''Cryptococcus'' spp.		** ''[[Cryptococcus]]'' spp.
	** ''Histoplasma capsulatum''		** ''[[Histoplasma capsulatum]]''
	** ''Coccidioides''		** ''[[Coccidioides]]''
	* Clinically-important but uncommon organisms		* Clinically-important but uncommon organisms
	** ''Legionella'' species		** ''[[Legionella]]'' species
	** Influenza A and B, including avian influenza A H5N1 and avian influenza A H7N9		** [[Influenza]] A and B, including avian influenza A H5N1 and avian influenza A H7N9
	** MERS-CoV and severe acute respiratory syndrome coronavirus (SARS-CoV)		** [[MERS-CoV]] and [[severe acute respiratory syndrome coronavirus]] (SARS-CoV)
	** Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA)		** Community-associated methicillin-resistant [[Staphylococcus aureus]] (CA-MRSA)

	== Clinical Presentation ==		== Clinical Presentation ==