Q: 65 years old male is admitted to ICU with community-acquired pneumonia (CAP). The presence of infiltrate on chest x-ray is required to establish the diagnosis of CAP?
The Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) guideline requires the demonstration of an infiltrate on chest imaging to establish the diagnosis of CAP when relevant symptoms are present such as fever, dyspnea, and productive cough.
Said that these symptoms and infiltrate on chest imaging can be present in other pulmonary as well as non-pulmonary pathologies too. This calls for systematic exclusion of other diseases in differential diagnosis.
Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med 2019; 200:e45.