Community-Acquired Pneumonia in Adults

Kolditz, Martin; Ewig, Santiago

doi:10.3238/arztebl.2017.0838

Cited by 54 publications

(71 citation statements)

References 56 publications

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“…Pneumonia is an extremely common, yet exceedingly dangerous condition that makes up 423,000 emergency room visits and is the 8th leading cause of death in the United States, according to the CDC [1]. Inpatient community-acquired pneumonia (CAP) treatment is often empiric and laboratory testing may not result in a definite organism [2]. It has been demonstrated that the microbial etiology of roughly 30%-60% of CAPs treated in the inpatient setting remains unidentified [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Severity of disease and mortality for hospitalized patients with community-acquired viral pneumonia compared to patients with community-acquired bacterial pneumonia

Kim¹,

Chandler²,

Furmanek³

et al. 2019

JRI

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Background: There exists a large body of literature to help identify, diagnose, treat, and manage community-acquired pneumonia (CAP). Despite this, there is little data that directly compares the clinical syndromes and complications of pure bacterial pneumonia to pure viral pneumonia. Our study compares the clinical presentation, morbidity and mortality of viral vs. bacterial etiologies of CAP. Methods: This was a secondary data analysis of the Community-Acquired Pneumonia Organization (CAPO) international study database. Data was collected concerning patient demographics, physical examination findings, laboratory findings, radiological findings, severity of illness, and clinical outcomes and stratified according to the two study groups, CAVP and CABP. A microbiological diagnosis of CABP was based on the isolation of a bacterium from a respiratory sample, blood culture and/or identification of a urinary antigen for Streptococcus or Legionella; microbiological diagnosis of CAVP was based on polymerase chain reaction or antigen detection from respiratory samples. Results: Our study included 1,913 patients. Of these, 286 (15.0%) had viral infection, while 1,627 (85.0%) had CAVP. We found that bacterial CAP patients are older, more frequently male, and suffer from a higher proportion of comorbidities when compared to viral CAP patients. Comparison of physical exam findings and laboratory values failed to find a clinically significant difference between bacterial and viral CAP patients. When comparing severity of illness, bacterial CAP patients had greater frequency of PSI ≥ class IV; however, viral CAP patients more frequently needed ICU admission, ventilator support, vasopressor support, and had higher rate of in hospital mortality. Conclusions: Our study confirms the extreme difficulty differentiating CABP from CAVP using demographics, physical exam, or x-ray findings. We found no major clinical or laboratory findings distinguishing CABP from CAVP. The increased severity of illness of CAVP compared to bacterial etiologies shows that PSI scores may not be an accurate indicator of severity of disease. More studies are needed to identify the best process of care for patients with CAP, including the potential benefits of routine respiratory viral panel testing and empiric antiviral therapy.

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Section: Introductionmentioning

confidence: 99%

Severity of disease and mortality for hospitalized patients with community-acquired viral pneumonia compared to patients with community-acquired bacterial pneumonia

Kim¹,

Chandler²,

Furmanek³

et al. 2019

JRI

View full text Add to dashboard Cite

show abstract

“…The newly onset lower respiratory syndromes with new lung in ltrate on chest radiograph, especially when supported by laboratory ndings and compatible physical examinations, is considered indicative for diagnosing community-acquired pneumonia (CAP) [11]. The clinical and radiological manifestations of COVID-19 may have some overlap with the manifestations of CAP caused by other pathogens, such as In uenza-A viral, Mycoplasma pneumoniae and Chlamydia pneumoniae and Streptococcus pneumoniae [12].…”

Section: Introductionmentioning

confidence: 99%

Comparison of initial thin-section CT features in coronavirus disease 2019 pneumonia and other community-acquired pneumonia

Zhu

Ren

Wang³

2020

Preprint

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Background Coronavirus disease 2019 (COVID-19) pneumonia caused similar symptoms to other community-acquired pneumonia (CAP). It is important to early quarantine suspected patients with COVID-19 pneumonia from patients with other CAP to reduce cross infection. The purpose of the study is to review and compare initial thin-section computed tomography (CT) features in patients with coronavirus disease 2019 (COVID-19) pneumonia and other community-acquired pneumonia (CAP). Methods 24 cases of COVID-19 pneumonia (14 males and 10 females; age range, 14-87 years; mean age, 48.0 years) and 28 cases of CAP caused by other pathogens (13 males and 15 females; age range, 24-85 years; mean age, 49.5 years) were included. Thin-section CT features of the lungs for all patients were retrospectively reviewed by two independent radiologists. Results There were no significant differences for the shape of main lesions, pure ground glass attenuation (GGA), mixed GGA with consolidation, air bronchogram, linear opacities, halo sign/reversed halo sign, cavitation and lymphadenopathy between the group of COVID-19 pneumonia and the group of other CAP. However, the frequency of crazy-paving appearance, vessel dilatation, bilaterally involvement and peripherally distribution were significantly higher in patients with COVID-19 compared with other CAP ( p =0.031, p =0.000, p =0.029 and p =0.009, respectively). Conversely, the frequencies of pure consolidation, tree-in-bud sign and pleural effusion were significantly higher in patients with CAP than in patients with COVID-19 pneumonia ( p =0.002, p =0.000 and p =0.048, respectively). Conclusion There are considerable overlaps in thin-section CT features between COVID-19 pneumonia and other CAP. However, the presence of crazy paving pattern, vessel dilation, bilateral involvement and peripheral distribution contributes to the diagnosis of COVID-19 pneumonia. While the presence of pure consolidation tree-in-bud sign, pleural effusion can be assisting in exclusive the diagnosis of COVID-19 pneumonia.

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“…Sie stellt ein zunehmendes Gesundheitsproblem der immer älter werdenden Bevölkerung dar. Mit jeder Lebensdekade steigt die Inzidenz der Erkrankung [2]. Gleichzeitig kommt es alterskorreliert zu wachsenden Mortalitätsraten [3].…”

Section: Introductionunclassified

Ambulant erworbene Pneumonie bei älteren Menschen

Schöll¹,

Rohde²

2020

Geriatrie up2date

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Community-Acquired Pneumonia in Adults

Abstract: Major considerations include appropriate risk stratification and the implementation of a management strategy adapted to the degree of severity of the disease, along with the establishment of structured follow-up care and secondary prevention, especially for patients with comorbidities.

Cited by 54 publications

References 56 publications

Severity of disease and mortality for hospitalized patients with community-acquired viral pneumonia compared to patients with community-acquired bacterial pneumonia

Severity of disease and mortality for hospitalized patients with community-acquired viral pneumonia compared to patients with community-acquired bacterial pneumonia

Comparison of initial thin-section CT features in coronavirus disease 2019 pneumonia and other community-acquired pneumonia

Ambulant erworbene Pneumonie bei älteren Menschen

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