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: - Peak expiratory flow rate monitoring for asthma - Chest X-ray PA and lateral (infiltrates, hyperinflation, effusions) - CT chest high-resolution for interstitial/parenchymal disease - Polysomnography for sleep-disordered breathing - Bronchoscopy with BAL for diagnostic sampling - Thoracentesis with Light criteria for pleural effusion classification - D-dimer (high sensitivity, low specificity for PE)
Risk factors: - Age >65 with declining mucociliary clearance - Indoor air pollution and biomass fuel exposure - Family history of alpha-1 antitrypsin deficiency - Prior TB exposure or latent TB infection - Environmental allergen sensitization (dust mites, mold, pollen) - Prematurity with bronchopulmonary dysplasia history - GERD with chronic microaspiration