Inappropriate and unnecessary antibiotics are common in primary care, urgent care, and emergency room settings. It can be difficult to distinguish whether community-acquired pneumonia (CAP) is due to a bacterial, viral, or fungal etiology. Clinicians should consider all three etiologies on CAP presentation to improve antimicrobial stewardship and patient outcomes.
A 47-year-old man presents to his primary care provider in Rhode Island for evaluation of possible community-acquired pneumonia. His past medical history includes hypertension and occasional gastrointestinal reflux disease. He has a cough, fever, and mild shortness of breath but no other symptoms. His clinician sends him home with a prescription for doxycycline 100 mg twice daily for 5 days. Two weeks later, the patient returns to their primary care provider with worsening shortness of breath and no improvement. The primary care provider takes a more detailed history and notes that:
Patient's father died from cardiovascular disease at age 52 years
Patient recently returned from camping in northern Minnesota
Patient has been taking melatonin to help with insomnia
Public Information from the CDC and Medscape
Cite this: Three Cases of Community-Acquired Pneumonia: Is It Bacterial, Viral, or Fungal? - Medscape - Sep 18, 2023.