Clinical Citations: Pneumonia: A red flag for a serious comorbidity

The initial evaluation of a patient with community-acquired pneumonia (CAP) should include a careful search for comorbidities, according to a study by Falguera and associates.

The study included 600 patients with CAP, 80% of whom were hospitalized. Underlying diseases had been documented previously in 45% of the patients. One or more new comorbid conditions were identified during the study in 6% of patients. The most common newly recognized comorbidities were diabetes, malignancy, chronic obstructive pulmonary disease, and HIV infection.

The patients who had new comorbidities were more likely than the others to have bacterial CAP and positive blood cultures, and they were more likely to require hospitalization.

The authors say that their findings are a reminder that CAP can be the first manifestation of an underlying disease, and they recommend that patients with CAP have an extensive evaluation directed at detecting comorbidities.