Acute lower respiratory infection with consolidation on imaging, acquired outside hospital.
Causes
- • S. pneumoniae (most common)
- • H. influenzae
- • Mycoplasma, Chlamydia, Legionella
- • Influenza, RSV, SARS-CoV-2
Clinical features
- • Fever, productive cough
- • Pleuritic chest pain
- • Dyspnoea
Examination
- • Tachypnoea, dull percussion
- • Bronchial breathing, crackles
- • Increased vocal resonance
Investigations
- • CXR (consolidation)
- • FBC, U&E, CRP
- • Sputum + blood cultures if severe
- • Pneumococcal + Legionella urinary antigen
- • Viral PCR
Diagnosis
- • CURB-65 0–1 outpatient, 2 ward, ≥3 ICU consideration
Management
- • Mild: amoxicillin 500 mg–1 g TDS PO
- • Moderate: amoxicillin + clarithromycin
- • Severe: co-amoxiclav + clarithromycin IV
- • 5–7 days typically
Complications
- • Para-pneumonic effusion / empyema
- • Sepsis, ARDS
- • Lung abscess
Clinical pearls
- • Atypical cover (macrolide) for moderate–severe CAP
- • Re-image at 6 weeks if persistent symptoms
References
- • NICE NG138
- • BTS CAP 2009
Related in WardRound
Educational — verify locally.
