Cough +/- Sputum

Shortness of breath

Rash (Mycoplasma)

Diarrhea (Legionella)

Fever, Rigors, Malaise

• Increased age• COPD/Asthma• EtOH, Tobacco• CHF, CVA, DM

• Bronchiectasis• Colonization• Immunosuppressed• Multi-lobar

• Influenza• Coronavirus• Adenovirus• RSV

• S. Pneumo• M. Pna• Legionella

• MRSA• Pseudo>

Virus Bacteria

All Pseudomonas

MRSA

• Parapneumonic e�.• Bacteremia• ARDS• Endo/Pericarditis

1. Clinical syndrome 2. CXR infiltrate

Outpatient

COMMUNITY ACQUIRED PNEUMONIA

• Post-flu• Colonization• IVDU

• Necrotizing PNA• Empyema• ESRD

• Empyema• Lung Abscess• Necrotizing PNA

Inpatient*No improvement?

See Abx failure schema

Pseudomonasrisk factors

+ Anti-PseudomonalB-lactam

MRSArisk factors

Severe?

B-lactam+

Macrolide

B-lactam+

Resp FQ

or

B-lactam+

Macrolideor

+ VancLinezolid

or

Y

Resp FQ

N

Amoxicillin/Clavulanate+

Macrolide or Doxycycline

RespiratoryFluroquinolone

Amoxicillin

Macrolide

Doxycycline

or

oror

Risk factorsY N

Treatment

DiagnosisClinical Manifestations

Natural Course

Complications

Micro

Risk Factors

PathophysiologyC

linic

al S

tabi

lity

Days

Droplets Nasopharynx Microaspiration

Pneumonia

Immune function

Clearance

“inflammation + lung”CT in select cases