Hospital management of community-acquired pneumonia with respiratory complications: a case study
DOI:
https://doi.org/10.71068/hs000104Keywords:
community-acquired pneumonia, respiratory failure, hospitalization, antibiotics, oxygen therapy.Abstract
Introduction: This case addresses neumonía adquirida en la comunidad grave con insuficiencia respiratoria hipoxémica, a clinically relevant condition in which early recognition, structured assessment, and risk-adapted treatment can substantially modify outcomes. The presentation illustrates how nonspecific or complex findings may delay diagnosis when they are interpreted separately. Objective: To describe the diagnostic reasoning, individualized intervention, multidisciplinary decisions, and clinical evolution of an adult patient with neumonía adquirida en la comunidad grave con insuficiencia respiratoria hipoxémica. Case presentation: A 67-year-old patient presented with fiebre, tos productiva, dolor pleurítico y disnea progresiva de cuatro días, con deterioro marcado durante las últimas doce horas. Clinical assessment, laboratory testing, targeted imaging, differential diagnosis, treatment, and follow-up were documented sequentially. Results: The integrated evaluation established neumonía adquirida en la comunidad grave con insuficiencia respiratoria hipoxémica y derrame parapneumónico no complicado. Management included antibioterapia empírica intravenosa, oxigenoterapia de alto flujo, fisioterapia respiratoria, control metabólico y reevaluación seriada; corticoide sistémico tras valoración de gravedad. The patient showed mejoría de oxigenación durante 72 horas, descenso de marcadores inflamatorios, transición a cánula convencional, movilización precoz y alta al noveno día. Conclusions: The case highlights the value of linking diagnostic probability, objective severity, repeated reassessment, and individualized treatment. A favorable outcome depended on timely decisions, coordinated care, and a structured follow-up plan rather than on a single diagnostic test or isolated intervention.
References
1. Jones BE, Herman DD, Dela Cruz CS, Waterer GW, Metlay JP, Ruminjo JK, et al. Summary for clinicians: clinical practice guideline for the diagnosis and treatment of community-acquired pneumonia. Ann Am Thorac Soc. 2020;17(2):133-138. https://doi.org/10.1513/AnnalsATS.201909-704CME.
2. Cook LK, Wulf JA. Community-acquired pneumonia: a review of current diagnostic criteria and management. Am J Nurs. 2020;120(12):34-42. https://doi.org/10.1097/01.NAJ.0000723420.30838.97.
3. Calabretta D, Martín-Loeches I, Torres A. New guidelines for severe community-acquired pneumonia. Semin Respir Crit Care Med. 2024;45(2):274-286. https://doi.org/10.1055/s-0043-1777797.
4. Dequin PF, Meziani F, Quenot JP, Kamel T, Ricard JD, Badie J, et al. Hydrocortisone in severe community-acquired pneumonia. N Engl J Med. 2023;388(21):1931-1941. https://doi.org/10.1056/NEJMoa2215145.
5. Saleem N, Kulkarni A, Snow TAC, Ambler G, Singer M, Arulkumaran N. Effect of corticosteroids on mortality and clinical cure in community-acquired pneumonia. Chest. 2023;163(3):484-497. https://doi.org/10.1016/j.chest.2022.08.2229.
6. Bergmann F, Pracher L, Sawodny R, Blaschke A, Gelbenegger G, Radtke C, et al. Efficacy and safety of corticosteroid therapy for community-acquired pneumonia. Clin Infect Dis. 2023;77(12):1704-1713. https://doi.org/10.1093/cid/ciad496.
7. Cheema HA, Musheer A, Ejaz A, Paracha AA, Shahid A, Rehman MEU, et al. Efficacy and safety of corticosteroids for the treatment of community-acquired pneumonia. J Crit Care. 2024;80:154507. https://doi.org/10.1016/j.jcrc.2023.154507.
8. Chaudhuri D, Israelian L, Putowski Z, Prakash J, Pitre T, Nei AM, et al. Adverse effects related to corticosteroid use in sepsis, ARDS, and community-acquired pneumonia. Crit Care Explor. 2024;6(4):e1071. https://doi.org/10.1097/CCE.0000000000001071.
9. Vaughn VM, Dickson RP, Horowitz JK, Flanders SA. Community-acquired pneumonia: a review. JAMA. 2024;332(15):1282-1295. https://doi.org/10.1001/jama.2024.14796https://doi.org/10.1097/CCE.0000000000001071.
10. Cavallazzi R, Ramirez JA. Definition, epidemiology, and pathogenesis of severe community-acquired pneumonia. Semin Respir Crit Care Med. 2024;45(2):143-157. https://doi.org/10.1055/s-0044-1779016https://doi.org/10.1097/CCE.0000000000001071.
11. Ferrer M, De Pascale G, Tanzarella ES, Antonelli M. Severe community-acquired pneumonia: noninvasive mechanical ventilation, intubation, and HFNT. Semin Respir Crit Care Med. 2024;45(2):169-186. https://doi.org/10.1055/s-0043-1778140https://doi.org/10.1097/CCE.0000000000001071.
12. Bassetti M, Giacobbe DR, Magnasco L, Fantin A, Vena A, Castaldo N. Antibiotic strategies for severe community-acquired pneumonia. Semin Respir Crit Care Med. 2024;45(2):187-199. https://doi.org/10.1055/s-0043-1778641https://doi.org/10.1097/CCE.0000000000001071.
13. Póvoa P, Pitrowsky M, Guerreiro G, Pacheco MB, Salluh JIF. Biomarkers: are they useful in severe community-acquired pneumonia? Semin Respir Crit Care Med. 2024;45(2):200-206. https://doi.org/10.1055/s-0043-1777771https://doi.org/10.1097/CCE.0000000000001071
14. Méndez R, González-Jiménez P, Mengot N, Menéndez R. Treatment failure and clinical stability in severe community-acquired pneumonia. Semin Respir Crit Care Med. 2024;45(2):225-236. https://doi.org/10.1055/s-0043-1778139https://doi.org/10.1097/CCE.0000000000001071.
15. Chaudhuri D, Nei AM, Rochwerg B, Balk RA, Asehnoune K, Cadena R, et al. 2024 focused update: guidelines on use of corticosteroids in sepsis, acute respiratory distress syndrome, and community-acquired pneumonia. Crit Care Med. 2024;52(5):e219-e233. https://doi.org/10.1097/CCM.0000000000006172https://doi.org/10.1097/CCE.0000000000001071.
16. See XY, Wang TH, Chang YC, Lo J, Liu W, Choo CYW, et al. Impact of different corticosteroids on severe community-acquired pneumonia: a systematic review and meta-analysis. BMJ Open Respir Res. 2024;11(1):e002141. https://doi.org/10.1136/bmjresp-2023-002141https://doi.org/10.1097/CCE.0000000000001071.
17. Chiang CH, See XY, Wang TH, Chang YC, Lo JE, Liu WT, et al. Effects of corticosteroids on severe community-acquired pneumonia: a closer look at the evidence. Crit Care. 2023;27(1):336. https://doi.org/10.1186/s13054-023-04614-3https://doi.org/10.1097/CCE.0000000000001071.
18. Raess N, Schuetz P, Cesana-Nigro N, Winzeler B, Urwyler SA, Schaedelin S, et al. Influence of prednisone on inflammatory biomarkers in community-acquired pneumonia: secondary analysis of a randomized trial. J Clin Pharmacol. 2021;61(11):1406-1414. https://doi.org/10.1002/jcph.1914https://doi.org/10.1097/CCE.0000000000001071.
19. Bonsall JM. Community-acquired pneumonia for the hospitalist: updates and controversies. J Brown Hosp Med. 2024;3(1):91180. https://doi.org/10.56305/001c.91180https://doi.org/10.1097/CCE.0000000000001071.
20. Venturas JP, Richards GA, Feldman C. Severe community-acquired pneumonia at a tertiary academic hospital in Johannesburg, South Africa. Respir Med. 2024;234:107823. https://doi.org/10.1016/j.rmed.2024.107823https://doi.org/10.1097/CCE.0000000000001071.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Joel David Bastidas Jimbo

This work is licensed under a Creative Commons Attribution 4.0 International License.
Articles published in this journal are available under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence. This licence authorises third parties to download, copy, distribute, adapt and reuse the contents, including for commercial purposes, provided that credit is given to the original author of the work.


