Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- tos con aumento de la producción de esputo
- disnea
- dolor torácico pleurítico
- rigores o sudores nocturnos
- fiebre
- hallazgos en la auscultación anormales
- confusión
- presencia de factores de riesgo
Другие диагностические факторы
- mialgia
- malestar general
- anorexia
- letargo
- empeoramiento de las condiciones preexistentes
- dolor de garganta
- cefalea
- náuseas
- dolor abdominal
- diarrea
Факторы риска
- edad >65 años
- residencia en un contexto de asistencia sanitaria
- Enfermedad pulmonar obstructiva crónica (EPOC)
- exposición al humo de cigarrillo
- abuso de alcohol
- higiene bucal deficiente
- fármacos que reducen el ácido
- contacto con niños
- diabetes mellitus
- nefropatía crónica
- hepatopatía crónica.
- uso de opiáceos
Диагностические исследования
Исследования, которые показаны в первую очередь
- radiografía de tórax
- oximetría de pulso
- gasometría arterial (GSA)
- urea y electrolitos
- hemograma completo
- proteína C reactiva (PCR)
- pruebas de función hepática
Исследования, проведение которых нужно рассмотреть
- hemocultivo
- cultivo de esputo (tinción de Gram ±)
- prueba de antígenos en orina para Legionella y neumococo
- reacción en cadena de la polimerasa (PCR) y/o pruebas serológicas
- exploración de tórax por TC
- ecografía de tórax
- toracocentesis y cultivo del líquido pleural
- angiografía pulmonar por tomografía computarizada (APTC)
- broncoscopia
- procalcitonina sérica
- PCR en el punto de atención
Алгоритм лечения
Составители
Эксперты-консультанты
Jonathan Bennett, MD
Honorary Professor of Respiratory Sciences
University of Leicester
Respiratory Consultant
Glenfield Hospital
Leicester
UK
Биография
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.
Раскрытие информации
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
Раскрытие информации
CC and AT are each authors of a number of references cited in this topic.
Рецензенты
Wei Shen Lim
Consultant Respiratory Physician and Honorary Professor of Medicine
Nottingham University Hospitals NHS Trust
Nottingham
UK
Раскрытие информации
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
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.Полный текст Аннотация
National Institute for Health and Care Excellence. Pneumonia in adults: diagnosis and management. July 2022 [internet publication].Полный текст
British Thoracic Society. 2015 - Annotated BTS guideline for the management of CAP in adults (2009) summary of recommendations. Jan 2015 [internet publication].Полный текст
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.Полный текст Аннотация
National Institute for Health and Care Excellence. Pneumonia (community-acquired): antimicrobial prescribing. Sep 2019 [internet publication].Полный текст
Статьи, указанные как источники
A full list of sources referenced in this topic is available here.
Использование этого контента попадает под действие нашего заявления об отказе от ответственности