Community-Acquired Pneumonia in the Emergency Department

Show Notes

• Pneumonia and nomenclature: healthcare associated vs hospital associated
• COVID-19 and antibiotics 
• Bacteriology - Strep is only 10-15% of hospitalized pneumonia, Viral pneumonia is about 20% (pre-COVID)
• Conditions that predispose to pneumonia
  • Chronic lung disease (chronic obstructive pulmonary disease, bronchiectasis)
  • Smoking
  • Older age
  • Immunocompromised 
  • Proton-pump inhibitors, H2 blockers, and antipsychotic agents 
• Is there a historical or exam item most likely to be indicative of pneumonia? 
• How good is a chest x-ray? 
• When should you consider a CT if the chest x-ray is normal?
• Procalcitonin
• Blood cultures, sputum cultures, urine antigens- are these helpful?
•  CURB-65 vs PSI
• Antibiotics: major and minor, history of prior infection, and doxy for everyone!
  • Duration - 5 days works
• A walk through the pathway

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