[New challenges in community-acquired pneumonia]

Community-acquired pneumonia is a major cause of morbidity and mortality. Severity assessment is a fundamental tool in the management of pneumonia that allows patients to be stratified according to risk of death and the most appropriate treatment intensity to be provided. The most widely used scales are the PSI/Fine and CURB-65 scales, which have been widely validated and are easy to calculate in clinical practice. Biomarkers can additionally be used to increase accuracy in predicting complications and mortality. Etiologic diagnosis of pneumonia continues to pose a challenge to clinicians. With the experience acquired in the 2009 AH1/N1 influenza pandemic, virological diagnosis of pneumonia by rapid polymerase chain reaction techniques has recently begun to be used. Experience has also been gained in antiviral treatment and complications, especially bacterial superinfection as the main unfavorable event in viral pneumonias. Just as the use of antibiotics to treat infections radically changed their prognosis and treatment, reports in the literature have progressively began to appear of the immunomodulatory effect of drugs that were not initially designed for the treatment of pneumonia, leading to hope for the potential modification of outcome in these patients.