Clinical meaning
Pneumonia involves alveolar consolidation from infection. CAP: S. pneumoniae most common. CURB-65 guides disposition: 0-1 outpatient, 2 consider admission, >=3 ICU. Outpatient: amoxicillin or doxycycline (healthy) or FQ/beta-lactam+macrolide (comorbidities). Procalcitonin <0.25 suggests viral.
Diagnosis & workup
Diagnostics & workup: - CT chest high-resolution for interstitial/parenchymal disease - 6-minute walk test for functional capacity assessment - Methacholine challenge for suspected asthma with normal spirometry - Sputum culture, Gram stain, and AFB stain - CT pulmonary angiography for PE evaluation - Bronchoscopy with BAL for diagnostic sampling - Pulse oximetry and continuous SpO2 monitoring
Risk factors: - Family history of alpha-1 antitrypsin deficiency - Connective tissue disease with ILD predisposition - Radiation therapy to chest - Immunocompromised state increasing pneumonia susceptibility - Childhood asthma with persistent airway hyperreactivity - Environmental allergen sensitization (dust mites, mold, pollen) - Obesity with restrictive physiology and OSA