The term community-acquired pneumonia (CAP) refers to a common lower respiratory infection diagnosed by a combination of some or all of the following: clinical signs and symptoms, an infiltrate seen on chest radiography, and abnormal laboratory values. It occurs outside of the hospital, or within 48 hours after hospital admission in a patient who has not been recently hospitalised and is not living in a long-term care facility. Pneumonia acquired in hospitCAPal or while living in an inpatient setting is referred to as “nosocomial pneumonia”. The clinical symptoms and signs of CAP include cough (with or without sputum production), fever, chills, tachypnoea, tachycardia, pleuritic chest pain, dyspnoea, altered mental status, dehydration, and hemoptysis; clinical findings will include a temperature greater than 37.8°C, heart rate over 100/min, respiratory rate greater than 25/min, oxygen saturations in room air < 90%, rhonchi or focal rales on auscultation of the lungs, decreased breath sounds, and bronchophony.
CAP is a major health problem worldwide and is associated with considerable morbidity, mortality and health care costs. However, although data are available from many prospective studies and national databases, it is difficult to determine the real clinical and economic impact of CAP for a number of reasons, the most common being that diagnostic certainty is usually only obtained in the hospital setting where (unlike the primary care setting) all diagnostic tools are readily available. ...
