Community-acquired pneumonia in pregnancy

Community-acquired pneumonia is a common disease worldwide, with considerable morbidity and mortality. In the United States, pneumonia complicates 0.5 to 1.5 per 1,000 pregnancies. Physiologic adaptations in the respiratory and immunologic systems may increase susceptibility to pulmonary infections as well as alter their clinical course. Bacterial, viral and fungal pathogens all cause pneumonia in pregnancy, although the causative agent is identified in only 40-60% of cases. The most common single pathogen is Streptococcus pneumoniae, which is identified in 15-20% of community-acquired pneumonia cases in pregnancy. Recent recommendations by the Infectious Diseases Society of America and the American Thoracic Society on the management of community-acquired pneumonia address diagnostic techniques and management schemes for bacterial and viral pneumonias. These guidelines are discussed in the setting of the pregnant woman with community-acquired pneumonia.