Snapshot A 36-year-old woman is brought to the emergency department for seizures that began 10 minutes prior to presentation with no clear precipitating cause. On physical exam, the patient is having a generalized tonic-clonic seizure. She is administered lorazepam and a second intravenous line is obtained for fosphenytoin, but the seizures do not abort. The patient is intubated, given propofol, and is admitted to the medical intensive care unit. On hospital day 3, the patient is difficult to wean from anticonvulsants and remains intubated. Her temperature is 101°F (38.9°C), blood pressure is 138/99 mmHg, pulse is 101/min, and respirations are 19/min with an oxygen saturation of 89% on room air. Physical examination is notable for crackles on the right anterior chest and a chest radiograph demonstrates a right lung lobar consolidation. Blood and sputum cultures are obtained and she is started on empiric antibiotic treatment, vancomycin and piperacillin-tazobactam, while cultures and sensitivities return. Introduction Definition login to view 4 more bullets Microbiology login to view 14 more bullets Epidemiology Incidence login to view 1 more bullet Risk factors login to view 4 more bullets Pathogenesis Virulent microorganisms enter the lower respiratory tract, resulting in an immunse response to the pathogen login to view 1 more bullet Presentation Symptoms login to view 4 more bullets Physical exam login to view 9 more bullets Imaging Chest radiograph login to view 4 more bullets Studies Making the diagnosis login to view 5 more bullets Sputum Gram stain and culture Blood cultures login to view 1 more bullet Other studies depend on clinical suspicion login to view 3 more bullets Bronchoscopy is considered in login to view 4 more bullets Differential COPD exacerbation login to view 2 more bullets Community-aquired pneumonia login to view 2 more bullets Treatment Medical login to view 14 more bullets Complications Respiratory failure Sepsis Septic shock Empyema login to view 1 more bullet Prognosis Associated with high mortality rates without antibiotics