COMMUNITY-ACQUIRED PNEUMONIA (CAP)

27 Septmber 2025, Saturday
COMMUNITY-ACQUIRED PNEUMONIA (CAP)

Community-acquired pneumonia is an acute infectious disease of the lower respiratory tract that develops outside the hospital setting or within the first 48 hours of hospital admission and affects the lung parenchyma.

Etiology

Pneumonia is primarily caused by:

1․ Bacterial infections, which can be:

Typical pathogens: Streptococcus pneumoniae (most common), Haemophilus influenzae, Staphylococcus aureus, Moraxella catarrhalis
Atypical pathogens: Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella spp. and others

2․ Viral infections: Rhinovirus, Adenovirus, Influenza A and B, Coronavirus, and others

3․ In many cases, the causative pathogen is not identified.

Diagnosis

Symptoms:
Fever, cough (productive or dry), dyspnea, chest pain, general weakness, tachypnea (>24 breaths/min), tachycardia (>100 bpm)

Auscultation findings in the lungs:

Decreased breath sounds, moist rales, crepitus, dullness to percussion.

Laboratory and instrumental investigations:

Complete blood count: leukocytosis with a left shift
C-reactive protein
In selected cases — procalcitonin
Sputum culture
Chest X-ray (in two projections)
Chest CT scan if necessary

Severity Assessment: CURB-65 Score

C – Confusion (altered mental status)
U – Urea >7 mmol/L
R – Respiratory rate >30/min
B – Blood pressure: systolic <90 mmHg or diastolic <60 mmHg
Age >65 years

Interpretation:

0–1 points: mild pneumonia, outpatient treatment
2 points: consider hospitalization
≥3 points: severe pneumonia, requires hospitalization, possibly ICU admission

Treatment

Adequate fluid intake, nutrition rich in protein and micronutrients
Moderate limitation of physical activity
Smoking cessation
Antipyretics and analgesics (e.g., acetaminophen or ibuprofen)
Empirical antibiotic therapy, chosen based on risk factors, comorbidities, individual characteristics (e.g., allergies), and clinical context
Antiviral therapy in case of viral etiology