1. Pnuemonia

2. 
Infants – S. agalactiae, L. monocytogenes, virus
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Children – RSV, S.
pneumoniae, Mycoplasma, Chlamydia
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Adults - S. pneumoniae, Mycoplasma, Chlamydia
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Elderly – S. pneumoniae, Influenza
virus,
H. influenza, anaerobes
Most Common Causes of
Community Acquired Pneumonia

3. 
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Chest pain
Dyspnea
Decreased exercise tolerance
Abdominal pain
Cough (sputum)
Fever / chills
Malaise
Non-specific symptoms:
myalgias, headache, abdominal
pain, nausea, vomiting, diarrhea, anorexia
and weight loss, and alter sensorium.
Presentation

4. CURB – 65 (predicts mortality)
confusion: AMT <8
urea >7mmol/L
respiratory rate >30
SBP <90 or DBP <60
age >65
Score: 2-3 = consider hospitalization
4-5 = must hospitalize
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Pneumonia Severity Index
considers many factors
Severity

5. Oxygen
 Fluids
 Empiric antibiotics
kids – amoxicillin, cefpodoxime
adults – macrolides(azithromycin, clarithromycin)
comorbidity – fluoroquinolones (levofloxacin)
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Management of CAP

6. 
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Stop smoking
Wash hands
Vaccines – measles, varicella, influenza
Children - Pneumococcal conjugate vaccine
Elderly – Pneumococcal polysaccharide vaccine
(Prevents bacteremia)
Prevention of Pneumonia