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Last reviewed: 21 Sep 2025
Last updated: 31 Jan 2023

Summary

Definição

História e exame físico

Principais fatores diagnósticos

  • cough with increasing sputum production
  • dyspnoea
  • pleuritic chest pain
  • rigors or night sweats
  • fever
  • abnormal auscultatory findings
  • confusion
  • presence of risk factors

Outros fatores diagnósticos

  • myalgia
  • malaise
  • anorexia
  • lethargy
  • worsening of pre-existing conditions
  • sore throat
  • headache
  • nausea
  • abdominal pain
  • diarrhoea

Fatores de risco

  • age >65 years
  • residence in a healthcare setting
  • COPD
  • exposure to cigarette smoke
  • alcohol abuse
  • poor oral hygiene
  • use of acid-reducing drugs
  • contact with children
  • diabetes mellitus
  • chronic renal disease
  • chronic liver disease
  • use of opioids

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • chest x-ray
  • pulse oximetry
  • arterial blood gas (ABG)
  • urea and electrolytes
  • full blood count
  • C-reactive protein (CRP)
  • liver function tests

Investigações a serem consideradas

  • blood culture
  • sputum culture (± Gram stain)
  • urinary antigen testing for legionella and pneumococcus
  • polymerase chain reaction (PCR) and/or serological tests
  • CT scan of chest
  • chest ultrasound
  • thoracocentesis and pleural fluid culture
  • computer tomographic pulmonary angiography (CTPA)
  • bronchoscopy
  • serum procalcitonin
  • point-of-care CRP

Algoritmo de tratamento

Colaboradores

Consultores especialistas

Jonathan Bennett, MD

Honorary Professor of Respiratory Sciences

University of Leicester

Respiratory Consultant

Glenfield Hospital

Leicester

UK

Biografia

JB is deputy medical director RCP Invited service Reviews, and speaker at National Society (e.g., BTS), Primary Care respiratory Society, and Society Cardiothoracic Surgeons meetings.

Declarações

JB declares that he has no competing interests.

Acknowledgements

BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work has been retained in parts of the content:

Catia Cilloniz MSc, PhD

Post-doctoral Research

Pneumology Department

Hospital Clinic of Barcelona

CIBERES

IDIBAPS

Barcelona

Spain

Antoni Torres MD, PhD

Professor of Medicine

Director

Pulmonary Intensive Care Unit

Respiratory Institute

Hospital Clinic of Barcelona

Barcelona

Spain

Declarações

CC and AT are each authors of a number of references cited in this topic.

Revisores

Wei Shen Lim

Consultant Respiratory Physician and Honorary Professor of Medicine

Nottingham University Hospitals NHS Trust

Nottingham

UK

Declarações

WSL was chairman of the British Thoracic Society community-acquired pneumonia guidelines committee and a member of the guideline development group for the National Institute for Health and Care Excellence pneumonia guidelines. His institution has received unrestricted investigator-initiated research funding from Pfizer for a multicentre study of pneumococcal pneumonia in which he was the chief investigator, and research funding from the National Institute for Health Research for studies in pneumonia in which he was the principal investigator. He is also an author of at least one reference cited in the topic.

Créditos aos pareceristas

Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.

Declarações

As afiliações e declarações dos pareceristas referem--se ao momento da revisão.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Lim WS, Baudouin SV, George RC, et al; Pneumonia Guidelines Committee of the BTS Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009 Oct;64(suppl 3):iii1-55.Texto completo  Resumo

National Institute for Health and Care Excellence. Pneumonia in adults: diagnosis and management. July 2022 [internet publication].Texto completo

British Thoracic Society. 2015 - Annotated BTS guideline for the management of CAP in adults (2009) summary of recommendations. Jan 2015 [internet publication].Texto completo

O'Driscoll BR, Howard LS, Earis J, et al. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax. 2017 Jun;72 (Suppl 1):ii1-90.Texto completo  Resumo

National Institute for Health and Care Excellence. Pneumonia (community-acquired): antimicrobial prescribing. Sep 2019 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível aqui.

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