Review article
https://doi.org/10.18054/pb.v127i1-2.35721
Severe community-acquired pneumonia
Gordana Pavliša
; University Hospital Center Zagreb, Clinic for Pulmonary Diseases, Zagreb, Croatia; University of Zagreb, School of Medicine, Zagreb, Croatia
*
Katarina Vukančić
; Institute of Emergency Medicine of Krapina-Zagorje County, Krapina, Croatia
Jelena Ivančić
orcid.org/0009-0009-9694-2644
; University of Zagreb, School of Medicine, Zagreb, Croatia
Alisa Zobel
; University of Zagreb, School of Medicine, Zagreb, Croatia
* Corresponding author.
Abstract
Background and purpose: Community-acquired pneumonia (CAP) represents a major global health concern due to its high morbidity and mortality. Severe community-acquired pneumonia (sCAP) is characterized by respiratory failure requiring invasive mechanical ventilation and/or septic shock. This narrative review outlines current diagnostic and therapeutic strategies for sCAP.
Materials and methods: A review of the bibliographic database PubMed was made.
Results: The primary bacterial pathogens include Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella pneumophila. In recent years, respiratory viruses, particularly influenza and SARS-CoV-2, have become increasingly recognized as significant etiological agents. This narrative review outlines current diagnostic and therapeutic strategies for sCAP. Diagnostic evaluation for hospitalized patients typically includes blood cultures, sputum Gram stain and culture, urinary antigen testing for S. Pneumoniae and Legionella, and screening for respiratory viruses. Multiplex polymerase chain reaction (PCR) assays capable of detecting a wide range of viral and bacterial pathogens are increasingly used. Management of sCAP involves immediate empirical antibiotic therapy, typically combining a β-lactam with a macrolide or a fluoroquinolone. Adjunctive therapies such as corticosteroids and antiviral medications may be considered in specific cases. Despite therapeutic advancements, sCAP remains associated with high mortality rates, reaching up to 35% in intensive care unit patients. Preventive measures including pneumococcal and influenza vaccination, smoking cessation, and timely medical intervention play a crucial role in reducing disease burden.
Conclusions: Continued research and clinical innovation are essential to improving outcomes and minimizing the global impact of sCAP.
Keywords
community-acquired pneumonia; pneumonia; intensive care units; vaccination; infectious diseases; respiratory tract infections
Hrčak ID:
340273
URI
Publication date:
1.12.2025.
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