Community-acquired pneumonia
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.D. [2]; Philip Marcus, M.D., M.P.H.[3]
Overview
Pathophysiology
Epidemiology & Demographics
Risk Factors
Natural History, Complications & Prognosis
Causes of Pneumonia
Differentiating Pneumonia from other Diseases
Physical Examination
Diagnosis
Diagnostic criteria
Treatment
Medical Therapy
Prevention
- Smoking cessation is important not only for treatment of any underlying lung disease, but also because cigarette smoke interferes with many of the body's natural defenses against CAP.
- Vaccinations against Haemophilus influenzae and Streptococcus pneumoniae in the first year of life have greatly reduced their role in CAP in children.
- A vaccine against Streptococcus pneumoniae and influenza are also available for adults and is currently recommended for all healthy individuals older than 65 and any adults with emphysema, congestive heart failure, diabetes mellitus, cirrhosis, alcoholism, cerebrospinal fluid leaks, or who do not have a spleen.
- A repeat vaccination may also be required after five or ten years.[4]
- In addition, health care workers, nursing home residents, and pregnant women should receive the vaccine.[5]
- When an influenza outbreak is occurring, medications such as amantadine, rimantadine, zanamivir, and oseltamivir have been shown to prevent cases of influenza.[6]
References
- ^ Emedicine review of bacterial pneumonia
- ^ Metaly JP, Schulz R, Li Y-H, Singer DE, Marrie TJ, Coley CM, Hough LJ, Obrosky DS, Kapoor WN, Fine MJ. Influence of age on symptoms at presentation in patients with community-acquired pneumonia. Arch Intern Med 1997; 157: 1453-1459 PMID 9224224
- ^ Metlay, JP, Kapoor, WN, Fine, MJ. Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination. JAMA 1997; 278:1440. PMID 9356004
- ^ Syrjala H, Broas M, Suramo I, Ojala A, Lahde S. High resolution computed tomography for the diagnosis of community-acquired pneumonia. Clin Infect Dis 1998; 27: 358-363 PMID 9709887
- ^ Webber, S, Wilkinson, AR, Lindsell, D, et al. Neonatal pneumonia. Arch Dis Child 1990; 65:207.PMID 2107797
- ^ Abzug, MJ, Beam, AC, Gyorkos, EA, Levin, MJ. Viral pneumonia in the first month of life. Pediatr Infect Dis J 1990; 9:881. PMID 2177540
- ^ Wubbel, L, Muniz, L, Ahmed, A, et al. Etiology and treatment of community-acquired pneumonia in ambulatory children. Pediatr Infect Dis J 1999; 18:98. PMID 10048679
- ^ de Roux, A, Marcos, MA, Garcia, E, et al. Viral community-acquired pneumonia in nonimmunocompromised adults. Chest 2004; 125:1343.PMID 15078744
- ^ Ruhe, JJ, Myers, L, Mushatt, D, Hasbun, R. High-level penicillin-nonsusceptible Streptococcus pneumoniae bacteremia: identification of a low-risk subgroup. Clin Infect Dis 2004; 38:508 PMID 14765343
- ^ Lieberman D, Schlaeffer F, Boldur I, Lieberman D, Horowitz S, Friedman MG, Leiononen M, Horovitz O, Manor E, Porath A. Multiple pathogens in adult patients admitted with community-acquired pneumonia: a one year prospective study of 346 consecutive patients. Thorax 1996; 51: 179-184 PMID 8711652
- ^ Bradley, JS. Management of community-acquired pediatric pneumonia in an era of increasing antibiotic resistance and conjugate vaccines. Pediatr Infect Dis J 2002; 21:592. PMID 12182396
- ^ Niederman MS, Mandell LA, Anzueto A, Bass JB, Broughton WA, Campbell GD, Dean N, File T, Fine MJ, Gross PA, et al. Guidelines for the management of adults with community-acquired pneumonia: diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Respir Crit Care Med 2001;163:1730–1754 PMID 11401897
- ^ Mundy, LM, Auwaerter, PG, Oldach, D, et al. Community-acquired pneumonia: impact of immune status. Am J Respir Crit Care Med 1995; 152:1309. PMID 7551387
- ^ Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE, Coley CM, Marrie TJ, Kapoor WN. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med 1997; 336: 243-250 PMID 8995086
- ^ Woodhead MA, MacFarlane JT, McCracken JS, Rose DH, Finch RG. Prospective study of the aetiology and outcome of pneumonia in the community. Lancet 1987; i: 671-674. PMID 2882091
- ^ Garenne, M, Ronsmans, C, Campbell, H. The magnitude of mortality from acute respiratory infections in children under 5 years in developing countries. World Health Stat Q 1992; 45:180. PMID 1462653
- ^ Almirall, J, Bolibar, I, Balanzo, X, Gonzalez, CA. Risk factors for community-acquired pneumonia in adults: A population-based case-control study. Eur Respir J 1999; 13:349. PMID 10065680
- ^ Butler JC, Breiman RF, Campbell JF, Lipman HB, Broome CV, Facklam RR. Pneumococcal polysaccharide vaccine efficacy: an evaluation of current recommendations. JAMA 1993; 270: 1826-1831. PMID 8411526
- ^ Centers for Disease Control and Prevention. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1999;48(RR-4):1-28.
- ^ Hayden FG, Atmar RL, Schilling M, Johnson C, Poretz D, Paar D, Huson L, Ward P, Mills RG. Use of the selective oral neuraminidase inhibitor oseltamivir to prevent influenza. N Engl J Med 1999; 341: 1336-1343 PMID 10536125