Pates, Katharine M;
Periselneris, Jimstan N;
Brown, Jeremy S;
(2023)
Pneumonia.
Medicine
, 51
(11)
pp. 763-767.
10.1016/j.mpmed.2023.08.003.
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Abstract
Pneumonia is a common lung infection that causes significant mortality and morbidity worldwide, particularly in children and elderly individuals. The diagnosis is confirmed by radiographic evidence of new consolidation. Pneumonia can be caused by a variety of microorganisms, with the dominant pathogens varying across the globe and between community- or hospital-acquired infections. Bacterial causes are usually acquired by microaspiration of organisms colonizing the nasopharynx. Microbes reaching the distal airways and alveoli induce local and systemic inflammatory responses and can disseminate beyond the lung. Although most cases of pneumonia occur in the community, a significant subset develop in hospital, often caused by multidrug-resistant bacteria, which are associated with higher mortality. Microbiological investigations are required to identify the pathogenic organism but lack sensitivity. Severity scoring systems can be used to predict outcome and identify patients who can be safely managed in outpatient settings. The mainstay of treatment is early antibiotics and, if appropriate, supportive therapies such as oxygen and intravenous fluids. Large vaccination programmes have proven effective in reducing the incidence of some of the causative organisms; however, the overall incidence of pneumonia remains high, and further research is required to improve care in at-risk groups such as the elderly.
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