A patient with community-acquired pneumonia (CAP) may develop clinical organ failure. The presence of an organ failure increases morbidity and mortality. It is essential to identify the cause early so that effective treatment can be started.
Clinical cardiorespiratory failure may include:
(1) respiratory failure
(2) shock
(3) heart failure
A relatively common cause is acute myocardial infarction (AMI), especially in the elderly and with severe pneumonia. Any patient with CAP should have the following performed on hospital admission or if there are signs of clinical deterioration:
(1) serial serum troponin level monitoring
(2) ECG review
Other reasons for clinical cardiorespiratory failure may include:
(1) septic shock
(2) pulmonary embolism
(3) empyema
(4) pneumothorax
(5) superimposed nosocomial infection
(6) progression in pneumonia due to antibiotic-resistance
(7) anaphylaxis
(8) bacterial endocarditis (especially with Staphylococcus aureus pneumonia)
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