Clinical Presentation of Severe CAP or Aspiration Pneumonia General

In approximately 10% of patients, CAP will be severe enough to require intensive care or mechanical ventilation

Symptoms

• Respiratory—cough (productive or nonproductive), shortness of breath, difficulty breathing

• Nonrespiratory—fever, fatigue, sweats, headache, myalgias, mental status changes Signs

• Temperature may increase or decrease from baseline, but most often it is elevated. The temperature may be sustained or intermittent

• Respiratory rate greater than 30 breaths per minute. Cyanosis and use of accessory muscles of respiration along with the increased respiratory rate are suggestive of severe respiratory compromise

• Hypotension (systolic blood pressure less than 90 mm Hg or diastolic blood pressure less than 60 mm Hg)

• Requirement for vasopressors

• Breath sounds may be diminished. Rales or rhonci may be heard

• Urine output less than 20 mL/h or less than 80 mL over 4 hours

• Confusion, lethargy, and disorientation are relatively common in elderly patients Diagnostic Tests

As stated in the clinical presentation of community-acquired or aspiration pneumonia Laboratory Tests

As stated in the clinical presentation of community-acquired or aspiration pneumonia Microbiology Tests

As stated in the clinical presentation of community-acquired or aspiration pneumonia

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