Community acquired pneumoniaBMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c2916 (Published 07 July 2010) Cite this as: BMJ 2010;341:c2916
- L Mandell, professor of medicine
- 1McMaster University, Division of Infectious Diseases, Henderson Hospital, 711 Concession Street, Hamilton, ON, Canada L8V 1C3
Community acquired pneumonia is an important cause of morbidity and mortality, yet it is often misdiagnosed and improperly treated. Guidelines have been produced by several societies, and these have helped to organise the approach to this disease; highlighted areas that need further research; and reduced length of stay, mortality, and costs in patients admitted to hospital.1 2 3 4 5
Recently a summary of the British Thoracic Society (BTS) guidelines for community acquired pneumonia was published that focuses on management in primary care.3 6 The guidelines are a manageable length for general practitioners and have important educational and quality assurance functions.
Some of the BTS recommendations however, differ from those of the Infectious Diseases Society of America (IDSA) and American Thoracic Society (ATS) guidelines. Although the practice of medicine and the prevalence of certain pathogens may differ between the United Kingdom and United States, certain problems are common on both sides of the Atlantic. The diagnosis of pneumonia is one of them.
There are two key factors in the diagnosis of community acquired pneumonia. The first is whether the patient actually has pneumonia and the second is identification of the pathogen responsible.
Several infectious and non-infectious entities can be confused with …
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