Community-acquired pneumonia

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Community-acquired pneumonia (CAP)

Microbiology

  • Bacteria
    • Typical organisms
      • Streptococcus pneumoniae
      • Haemophilus influenzae
      • Staphylococcus aureus
      • Group A streptococci
      • Moraxella catarrhalis
      • Anaerobes and aerobic gram-negative bacteria
        • Klebsiella pneumonia
        • Pseudomonas aeruginosa
        • Acinetobacter baumannii
    • Atypical organisms
      • Legionella spp.
      • Mycoplasma pneumoniae
      • Chlamydia pneumoniae
      • Chlamydia psittaci
    • Others
      • Coxiella burnetti
  • Viral
    • Influenza
    • Parainfluenza
    • RSV
    • Adenovirus
    • Human metapneumovirus
    • Middle East respiratory syndrome virus (MERS-CoV)
    • Rhinovirus
  • Fungi
    • Cryptococcus spp.
    • Histoplasma capsulatum
    • Coccidioides
  • Clinically-important but uncommon organisms
    • Legionella species
    • Influenza A and B, including avian influenza A H5N1 and avian influenza A H7N9
    • MERS-CoV and severe acute respiratory syndrome coronavirus (SARS-CoV)
    • Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA)

Clinical Presentation

  • If effusion, consider Legionella

Investigations

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

Management

Prognosis

Further Reading

References

  1. ^  Naomi J. Gadsby, Daniel M. Musher. The Microbial Etiology of Community-Acquired Pneumonia in Adults: from Classical Bacteriology to Host Transcriptional Signatures. Clinical Microbiology Reviews. 2022;35(4). doi:10.1128/cmr.00015-22.
  2. ^  Joshua P. Metlay, Grant W. Waterer, Ann C. Long, Antonio Anzueto, Jan Brozek, Kristina Crothers, Laura A. Cooley, Nathan C. Dean, Michael J. Fine, Scott A. Flanders, Marie R. Griffin, Mark L. Metersky, Daniel M. Musher, Marcos I. Restrepo, Cynthia G. Whitney. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. American Journal of Respiratory and Critical Care Medicine. 2019;200(7):e45-e67. doi:10.1164/rccm.201908-1581st.