Community-acquired pneumonia: Difference between revisions
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==[[Community-acquired pneumonia historical perspective|Classification]]== | ==[[Community-acquired pneumonia historical perspective|Classification]]== | ||
There is no established system for the classification of community-acquired pneumonia. However it can be classified according to severity using the Pneumonia Severity Index (PSI) score and CURB-65 Score. | |||
The PSI score is calculated using factors like age, demographic factors, comorbid illnesses, physical exam findings, radiographic and laboratory findings. Based on these factors, the severity of the disease can be classified into five risk categories. | |||
Patients in Risk Class 1 to II can be managed in outpatient settings with oral antibiotics. Patients in Risk Class III can be managed in outpatient or inpatient settings after evaluation of risk factors. Patients in class IV and V should be admitted in the hospital for treatment. Risk Class I - III represents mortality of 0.1 - 0.9% whereas risk class V represent a 27% probability of mortality. | |||
The CURB-65 score is also used to categorize patients according to disease severity. It is calculated using the following factors: | |||
New onset of Confusion. | |||
Blood Urea Nitrogen > 7 mmol/L or > 20 mg/dL. | |||
Respiratory Rate > 30 breaths/minute. | |||
Blood pressure less than 90 mmHg SBP or less than 60 DBP. | |||
Age > 65 years. | |||
Patients can be treated as outpatient with a score of 0 - 1, whereas score of 3 - 5 requires hospitalization. | |||
CRB-65 is a simplified version of the score which is sometimes used in primary care settings for decision making. Hospitalization is recommended if one or more points are present. | |||
==[[Community-acquired pneumonia pathophysiology|Pathophysiology]]== | ==[[Community-acquired pneumonia pathophysiology|Pathophysiology]]== | ||
Revision as of 06:25, 4 November 2020
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Resident Survival Guide |
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Community-Acquired Pneumonia Microchapters |
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Differentiating Community-acquired pneumonia from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Community-acquired pneumonia On the Web |
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American Roentgen Ray Society Images of Community-acquired pneumonia |
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Directions to Hospitals Treating Community-acquired pneumonia |
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Risk calculators and risk factors for Community-acquired pneumonia |
For the main page on pneumonia, click here.
For hospital-acquired pneumonia, click here.
For patient information on pneumonia, click here.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]; Nazma Hanif, MD[3]
Assistant Editor-In-Chief: Simran Singh
Synonyms and keywords: CAP
Overview
Historical Perspective
Classification
There is no established system for the classification of community-acquired pneumonia. However it can be classified according to severity using the Pneumonia Severity Index (PSI) score and CURB-65 Score.
The PSI score is calculated using factors like age, demographic factors, comorbid illnesses, physical exam findings, radiographic and laboratory findings. Based on these factors, the severity of the disease can be classified into five risk categories. Patients in Risk Class 1 to II can be managed in outpatient settings with oral antibiotics. Patients in Risk Class III can be managed in outpatient or inpatient settings after evaluation of risk factors. Patients in class IV and V should be admitted in the hospital for treatment. Risk Class I - III represents mortality of 0.1 - 0.9% whereas risk class V represent a 27% probability of mortality.
The CURB-65 score is also used to categorize patients according to disease severity. It is calculated using the following factors:
New onset of Confusion. Blood Urea Nitrogen > 7 mmol/L or > 20 mg/dL. Respiratory Rate > 30 breaths/minute. Blood pressure less than 90 mmHg SBP or less than 60 DBP. Age > 65 years.
Patients can be treated as outpatient with a score of 0 - 1, whereas score of 3 - 5 requires hospitalization. CRB-65 is a simplified version of the score which is sometimes used in primary care settings for decision making. Hospitalization is recommended if one or more points are present.
Pathophysiology
Causes
Differentiating Community-acquired pneumonia from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
Severity Criteria | History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | CT | Ultrasound | Other Diagnostic Studies
Treatment
Medical Therapy | Primary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies