ABSTRACT
Sir William Osler once referred to pneumonia as the “captain of the men of death,” and “the old man’s friend.”1,8 Despite advances in diagnostic techniques and advances in pharmacotherapy, pneumonia remains a common and potentially serious illness. In the United States, pneumonia is the sixth leading cause of death and the number one cause of death from infectious disease.2 In the elderly, pneumonia is the fourth overall leading cause of death and is the leading infectious cause of death in persons over 65 years of age.3 Mortality ranges from 1% to 5% for patients treated on an outpatient basis, but increases to 12% for patients requiring hospitalization; patients with hospital-acquired pneumonia have a mortality of 50% to 90%.2,4
Risk Factors Patients with coexisting illnesses are most prone to develop pneumonia. Patients with chronic renal insufficiency, diabetes mellitus, COPD, coronary artery disease, malignancy, chronic neurological disease, and chronic liver disease have a higher incidence of developing pneumonia (Table 24-1).2
