Periselneris, JN;
Brown, JS;
José, RJ;
(2020)
Pneumonia.
Medicine
, 48
(6)
pp. 351-355.
10.1016/j.mpmed.2020.03.002.
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Abstract
Pneumonia is a common lung infection that causes significant mortality and morbidity worldwide, particularly in children and elderly people. The microbiological aetiology varies by location, with a variety of viruses and bacteria causing disease. Bacterial causes are usually acquired by microaspiration of organisms colonizing the nasopharynx. Microbes reaching the distal airways and alveoli induce a local and sometimes systemic inflammatory response, as well as occasionally disseminating distal to 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. Pneumonia is diagnosed by chest radiology, identifying pulmonary infiltrates. Severity scoring systems can be used to predict outcome and identify patients who can be safely managed in an outpatient setting. Further investigations are sometimes required to identify the pathogenic organism. The mainstay of treatment is early antibiotics and, if appropriate, supportive therapies such as oxygen and intravenous fluids. Large vaccination programmes rolled out across much of the world 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 target groups such as the elderly.
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