Current Concepts of Severe Pneumococcal Community-acquired Pneumonia

Community-acquired pneumonia (CAP) is a major health problem, even in developed countries, being the leading cause of death due to infectious diseases in the USA [1]. CAP has a wide clinical spectrum of severity: up to 80% of patients are successfully managed in primary care, but 1 % of patients with CAP are classified as having severe disease, needing intensive care unit (ICU) admission, with 20–50% dying despite all available support and treatment options being utilized. Streptococcus pneumoniae is the most common cause of CAP, enclosing the subset group of patients having severe disease [2]. Moreover, bacteremia is not uncommon in pneumococcal CAP (20%) and has been associated with increased severity and mortality compared with non-bacteremic pneumonia [3].