Community-acquired pneumonia

Community-acquired pneumonia is a common problem. Though a wide range of pathogens are seen, Streptococcus pneumoniae remains the most common proven cause of lobar or segmental pneumonia. A chest x- ray should be performed in all suspected cases of pneumonia. Atypical pneumonia due to pathogens such as Mycoplasma pneumoniae is difficult to distinguish clinically and radiologically from other forms of pneumonia. The diagnosis of atypical pneumonia is largely retrospective, relying heavily on serological methods. Patients with community-acquired pneumonia need not all be hospitalized and oral or even home intravenous (IV) therapy may be used successfully in many cases. A macrolide or tetracycline should be used for 2-3 weeks to treat pneumonia due to Mycoplasma pneumoniae. Most other forms of pneumonia require treatment for approximately 10 days. With patients on IV therapy, change to oral therapy as soon as possible. Pneumococcal resistance to penicillin is increasing but to date this has not had significant impact in the treatment of chest disease. (author abstract)