We Often Get CAP Wrong: Case Challenges

Neil Gaffin, MD


June 13, 2019


We did not change the patient's current medical treatment. The recent upper respiratory infection in his wife and his clinical symptoms and exam, combined with detection of human metapneumovirus and the low procalcitonin value, all pointed to viral pneumonia as his diagnosis. He gradually improved over the next 2 weeks, with complete resolution of his respiratory illness.

Practice Implications

These cases illustrate an approach to the management of CAP that takes into consideration not only the shift in causative pathogens and the availability of new rapid diagnostic tests but also an awareness that antibiotic therapy, particularly if unnecessary, has the potential to cause harm at both the individual and societal level. This paradigm can safely curtail unnecessary days of antibiotic therapy, particularly when the clinical likelihood of a bacterial infection is low. We must all be antibiotic stewards if we are to avoid the catastrophic consequences of a postantibiotic era.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.