Inflammation of the lung parenchyma as a result of an infection. Community acquired (CAP) or hospital acquired (HAP) developing 48hrs after admission  

Certain groups are at increased risk of pneumonia: diabetics, COPD, previous splenectomy, underlying cardiorespiratory disease, elderly and HIV patients. 

Common Causes of CAP Common Causes of HAP

Streptococcus Pneumonia Gram Negative Bacteria

Haemophilus Influenza Staphylococcus Aureus

Mycoplasma Pneumonia Streptococcus Pneumonia

Pyrexia, dyspnea, tachypnoea, confusion, cough with purulent sputum. Auscultation may reveal crackles and bronchial breathing. A dull percussion note may be present

Pleuritic pain, productive cough, rigors and shortness of breath. 

Atypical Pneumonias cause atypical symptoms. 

Mycoplasma: Erythema multiforme (‘target lesions’), erythema nodosum and DIC. Legionella: Flu-like symptoms. Urine tested for antigen

Chest X-Ray: Consolidation and potentially pleural effusions

Bloods: FBC, U&E, CRP and liver function tests, ABG, blood cultures. 

Sputum culture and gram stain: Suspected cases of TB - Acid Fast Bacilli.

Urine antigen: Pneumococcal (moderate to high severity), legionella (high severity)

Bronchoscopy: in persistent cases post course of antibiotics

Dependent on CURB-65 Score.

Post discharge, patients should have a follow up Chest X-Ray at 6 weeks

Septicaemia, para-pneumonic effusions, empyema and cavity  formation