Community-acquired pneumonia (CAP) is one of the most common infectious diseases addressed by clinicians.

CAP is an important cause of mortality and morbidity worldwide. A number of pathogens can give rise to CAP. Typical bacterial pathogens that cause the condition include Streptococcus pneumoniae (penicillin-sensitive and -resistant strains), Haemophilus influenzae (ampicillin-sensitive and -resistant strains), and Moraxella catarrhalis (all strains penicillinresistant). These 3 pathogens account for approximately 85% of CAP cases.[1] CAP is usually acquired via inhalation or aspiration of pulmonary pathogenic organisms into a lung segment or lobe. Less commonly, CAP results from secondary bacteremia from a distant source, such as Escherichia coli urinary tract infection and/or bacteremia. Aspiration pneumonia is the only form of CAP caused by multiple pathogens (eg, aerobic/anaerobic oral organisms).

Severe CAP
Severe CAP develops in patients with cardiopulmonary disease, diminished splenic function, and/or pathogenic virulence. Even in young and/or healthy hosts, however, severe CAP can develop if the causative pathogen is sufficiently virulent. For example, influenza, severe acute respiratory syndrome (SARS), Hantavirus pulmonary syndrome (HPS), and Legionnaires disease may present as severe CAP.[2, 3, 4, 5] Patients with severe CAP should have the benefit of an infectious disease specialist to assist in the underlying cause of their condition.

CAP-associated complications
Complications in CAP depend on the infecting pathogen and patient health. For example, empyema can occur with Streptococcus pneumoniae, Klebsiella pneumoniae, and group A streptococcal CAP. (K pneumoniaeinfections occur in patients with chronic alcoholism.) Cavitation is not a feature of pneumococcal pneumonia, but it is a normal part of the disease process in K pneumoniae infections. Myocardial infarction can be precipitated by fever due to community-acquired pneumonia (CAP). Patients with CAP who have impaired splenic function may develop overwhelming pneumococcal sepsis, potentially leading to death within 12-24 hours, regardless of the antimicrobial regimen used.

Morbidity and mortality

CAP morbidity and mortality are highest in elderly patients and in immunocompromised hosts. Other factors that predict an increased risk of mortality in patients with CAP include the presence of significant comorbidities, an increased respiratory rate, hypotension, fever, multilobar involvement, anemia, and hypoxia.[6] For more information, see the following: y y y y y y y y y Mycoplasma Pneumonia Bacterial Pneumonia Viral Pneumonia Imaging Pneumocystis Carinii Pneumonia Aspiration Pneumonia Nosocomial Pneumonia Ventilator-Associated Pneumonia Pneumocystis (carinii) jiroveci Pneumonia Fungal Pneumonia

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Immunocompromised Pneumonia Nursing Home Acquired Pneumonia Chlamydial Pneumonia Lymphocytic Interstitial Pneumonia Imaging Typical Bacterial Pneumonia Imaging Atypical Bacterial Pneumonia Imaging Viral Pneumonia