Respiratory System

{"ops":[{"insert":"Complications of community acquired pneumonia"},{"insert":"\n","attributes":{"header":1}},{"insert":"Unfortunately, community acquired pneumonias often give rise to complications, due to misdiagnosis, delayed diagnosis, or inappropriate antibiotic therapy.\n\nThe most worrisome complications include massive pleural effusions, severe hypotension leading to severe hemodynamic changes, lung abscesses, lung cavitations, sepsis followed by shock and acute respiratory failure.\n\nLess severe complications include mild confusion, jaundice, hemoptysis, anemia and arthritis; they rarely give rise to clinical consequences.\n\nNote that bacterial pneumonias are more likely to give rise to complications (as opposed to viral infections).\n"},{"insert":"Inpatient or outpatient management?"},{"insert":"\n","attributes":{"header":1}},{"insert":"In patients with a community acquired pneumonia, the most pressing issue is whether they should be managed at home, or in a hospital setting.\n\nAccurate risk assessment is key to making this decision correctly; this can be performed via prospectively validated clinical tools such as the pneumonia severity index (PSI) and CURB-65 score.\n\nNote that the PSI is tedious to perform, as it uses 20 variables, some involving complex invasive investigations; it is thus not used in the primary care setting.\n\nThe CURB-65 score is much simpler, only requiring 5 variables; a blood urea nitrogen (BUN) level is the only investigation required; where a BUN is not available, the CRB-65 score can be used instead.\n"}]}

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