PNEUMONIA
Pneumonia, an infection of the lung parenchyma, is classified as community-acquired (CAP), hospital-acquired (HAP), ventilator-associated (VAP), or health care–associated (HCAP). Although the HCAP category initially referred to CAP caused by a multidrug-resistant (MDR) pathogen, it now describes pts with at least two or three risk factors for infection with MDR pathogens (Table 134-1).
MULTIDRUG-RESISTANT GRAM-NEGATIVE BACTERIA AND MRSA | NOSOCOMIAL MRSA | COMMUNITY-ACQUIRED MRSA |
---|---|---|
Hospitalization ≥2 days in previous 90 days Use of antibiotics in previous 90 days Immunosuppression Nonambulatory status Tube feedings Gastric acid suppression Severe COPD or bronchiectasisb | Hospitalization ≥2 days in previous 90 days Use of antibiotics in previous 90 days Chronic hemodialysis in previous 30 days Documented prior MRSA colonization Congestive heart failure Gastric acid suppression | Cavitary infiltrate or necrosis Gross hemoptysis Neutropenia Erythematous rash Concurrent influenza Young, previously healthy status Summer-month onset |
aCephalosporin/macrolide or respiratory fluoroquinolone.
bRisk for Pseudomonas aeruginosa infection.
Abbreviations: COPD, chronic obstructive pulmonary disease; MRSA, methicillin-resistant Staphylococcus aureus.
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Citation
Kasper, Dennis L., et al., editors. "PNEUMONIA." Harrison's Manual of Medicine, 20th ed., McGraw Hill Inc., 2020. harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623674/all/PNEUMONIA.
PNEUMONIA. In: Kasper DLD, Fauci ASA, Hauser SLS, et al, eds. Harrison's Manual of Medicine. McGraw Hill Inc.; 2020. https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623674/all/PNEUMONIA. Accessed November 10, 2024.
PNEUMONIA. (2020). In Kasper, D. L., Fauci, A. S., Hauser, S. L., Longo, D. L., Jameson, J. L., & Loscalzo, J. (Eds.), Harrison's Manual of Medicine (20th ed.). McGraw Hill Inc.. https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623674/all/PNEUMONIA
PNEUMONIA [Internet]. In: Kasper DLD, Fauci ASA, Hauser SLS, Longo DLD, Jameson JLJ, Loscalzo JJ, editors. Harrison's Manual of Medicine. McGraw Hill Inc.; 2020. [cited 2024 November 10]. Available from: https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623674/all/PNEUMONIA.
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