Community-Acquired Pneumonia

Question 1

What are the risk factors for community-acquired pneumonia?

Answer 1

• Age
• Immunocompromise
• Respiratory infection recently
• Recent travel
• Recent antibiotic therapy (opportunistic)
• Smoking

Question 2

What is the typical presentation of someone with community-acquired pneumonia?

Answer 2

• Cough (dry to productive)
• Dyspnoea
• Chest/abdo pain
• Tachypnoea
• Tachycardia
• Crackles/rales/bronchial breath sounds
• Lung percussion dullness
• Fever

Question 3

How might you investigate suspected community-acquired pneumonia?

Answer 3

• CXR (consolidation)
• FBE (neutrophilia)
• SaO2
• Blood/sputum culture if severe

Question 4

How might you manage community-acquired pneumonia?

Answer 4

• Stratify with SMARTCOP score
• Outpatient
  
  • Amoxycillin OR doxycycline if allergic
  • With comorbidities - levoflox/moxiflox or amoxi + clarithromycin
• Inpatient
  
  • Ben-pen AND doxycycline (moderate-risk)
  • Ceftriaxone AND azithromycin (high-risk)
• Supportive care
  
  • Fluids, O2 therapy, ventilation as required