Community-Acquired Pneumonia (CAP) in Adults

Flashcards for reviewing Community-Acquired Pneumonia

Community-Acquired Pneumonia (CAP)

Acute infection of lung parenchyma acquired outside of hospitals.

Incidence of CAP in Adults

Approximately 5.2–6.8 cases per 1,000 adults per year, with hospitalization increasing with age and comorbidities.

Typical Pathogens in CAP

S. pneumoniae, H. influenzae, M. catarrhalis.

Atypical Pathogens in CAP

M. pneumoniae, C. pneumoniae, Legionella spp.

Viral Pathogens in CAP

Influenza, RSV, SARS-CoV-2.

Aspiration Pathogens in CAP

Anaerobes, enteric gram-negatives.

CAP process

Inhalation or aspiration of organisms leads to multiplication, cytokine production, and neutrophil recruitment causing pulmonary and systemic issues.

Clinical Presentation of CAP

Symptoms include cough, fever, dyspnea, pleuritic chest pain, fatigue, confusion, tachypnea, and GI symptoms.

CAP Diagnosis

Symptoms + Chest X-ray showing infiltrates. Pulse oximetry or ABG for hypoxia. Labs: CBC, procalcitonin, cultures (if severe).

CURB-65

Severity assessment tool utilizing Confusion, Urea >7, RR ≥30, BP <90/60, Age ≥65.

PSI (PORT)

Detailed severity tool for assessing pneumonia.

Outpatient Treatment for CAP (no comorbidity)

Amoxicillin or doxycycline.

Outpatient Treatment for CAP (with comorbidity)

Amox-Clav + macrolide or fluoroquinolone.

Inpatient Treatment for CAP (non-ICU)

β-lactam + macrolide or fluoroquinolone alone.

ICU Treatment for CAP

β-lactam + azithromycin or fluoroquinolone.

Risk factors for drug-resistant pathogens

Recent antibiotics, structural lung disease, colonization, MRSA, Pseudomonas, or recent hospital exposure.

CAP Mortality

CAP Complications

Effusion, empyema, sepsis, lung abscess, RF.

Key elements of CAP management

CAP = Infection + infiltrate. Use CURB-65 or PSI for severity assessment. Tailor treatment by setting and comorbidities. Avoid broad-spectrum overuse. Recognize atypical signs in elderly.

Acute Bronchitis

Inflamed and edematous large airways.

Pneumonia

Pus, mucus, and fluid-filled alveoli which can lead to consolidation; inflamed and edematous small and large airways and surrounding parenchyma.