Three Cases of Community-Acquired Pneumonia: Is It Bacterial, Viral, or Fungal?

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.

Case #1

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.