community acquired pneumonia · 2020. 7. 5. · community acquired pneumonia • post-flu •...
TRANSCRIPT
Cough +/- Sputum
Shortness of breath
Rash (Mycoplasma)
Diarrhea (Legionella)
Fever, Rigors, Malaise
• Increased age• COPD/Asthma• EtOH, Tobacco• CHF, CVA, DM
• Bronchiectasis• Colonization• Immunosuppressed• Multi-lobar
• Influenza• Coronavirus• Adenovirus• RSV
• S. Pneumo• M. Pna• Legionella
• MRSA• Pseudo>
Virus Bacteria
All Pseudomonas
MRSA
• Parapneumonic e�.• Bacteremia• ARDS• Endo/Pericarditis
1. Clinical syndrome 2. CXR infiltrate
Outpatient
COMMUNITY ACQUIRED PNEUMONIA
• Post-flu• Colonization• IVDU
• Necrotizing PNA• Empyema• ESRD
• Empyema• Lung Abscess• Necrotizing PNA
Inpatient*No improvement?
See Abx failure schema
Pseudomonasrisk factors
+ Anti-PseudomonalB-lactam
MRSArisk factors
Severe?
B-lactam+
Macrolide
B-lactam+
Resp FQ
or
B-lactam+
Macrolideor
+ VancLinezolid
or
Y
Resp FQ
N
Amoxicillin/Clavulanate+
Macrolide or Doxycycline
RespiratoryFluroquinolone
Amoxicillin
Macrolide
Doxycycline
or
oror
Risk factorsY N
Treatment
DiagnosisClinical Manifestations
Natural Course
Complications
Micro
Risk Factors
PathophysiologyC
linic
al S
tabi
lity
Days
Droplets Nasopharynx Microaspiration
Pneumonia
Immune function
Clearance
“inflammation + lung”CT in select cases