Moreover, the elderly may have an atypical presentation because they cannot mount the immune response required to produce the typical pneumonia with cough, sputum, high grade fever and rapid onset. A patient is felt to have a severe pneumonia if the respiratory rate is over 30 more than one lobe involved pO2 is less than 60 sepsis with hypotension is present end organ dysfunction is present You can consult the Consensus Report if you want to see the specific ranking of the organisms that cause this disease. Strep Pneumonia is the most commonly found bacteria in all settings. Mycoplasma runs second in the less seriously ill patient under 65, otherwise H. flu is the second most popular bug. A Macrolide may be added if necessary.
Serology is only useful for epidemiological or research purposes and adds nothing to treatment.
Also it should be noted that resistance is developing to these treatments, so if the patient is not responding consider this option. For some test cases of community acquired pneumonia click here .