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4. 1 and 3
Community-acquired pneumonia (CAP) is common (1). The common symptoms of bacterial pneumonia include fever, cough, and sputum production (may or may not be present). The color and quality of sputum provide the clue to microbiological etiology. However, in the elderly presentation can be more subtle. There may be no fever or respiratory complaints and the elderly can present only with confusion. Of course, at this time in the middle of a pandemic, COVID-19 remains high on the differential.
Bacteria which cause CAP pneumonia include are Streptococcus pneumoniae, Staphylococcus aureus, Group A Streptococcus, Klebsiella pneumoniae, Hemophilus influenzae, Moraxella catarrhalis, anaerobes, and gram-negative organisms (1). Streptococcus pneumonia (also called Pneumococcus by some older physicians) was by far and away the most common cause of pneumonia 30-40 years ago and remains the most common cause. However, the other organisms appear to be increasing in incidence (1).
What should be done at this time? (Click on the correct answer to be directed to the third of seven pages)