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Severe Community Acquired Pneumonia
N. Markou, A. Damianos
SUMMARY: Severe community acquired pneumonia (CAP) is defined as CAP
that has to be treated in an Intensive Care Unit (ICU). Treatment in the ICU
may be needed because of: a) acute respiratory failure, b) hemodynamic instability,
c) monitoring and treatment of dysfunction of other organs or systems. Thus
severe CAP is CAP that results in severe sepsis or multiple organ failure. Severe
CAP is a syndrome with high mortality (20-50%), that demands early recognition
and immediate and aggressive treatment. At the same time an effort should
be made to isolate responsible pathogens, utilizing in selected cases, invasive
diagnostic techniques. Objective criteria can help to recognize these high risk
patients. Empirical treatment should provide adequate coverage for S. pneumoniae,
Gram (-) bacilli and Legionella pneumophila. Pneumon 2003, 16(2):126-141.
Key words: Community-acquired pneumonia, Intensive Care Unit, severity
criteria, diagnosis, treatment, prognosis, pathogens, sepsis, multiple organ
failure.
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