Severe pneumonia produces two categories of complications: physiological (hypoxia, septic shock, ARDS, renal impairment, deep vein thrombosis, atrial fibrillation, acute cardiac ischemia from physiological stress) and infective, where organisms or infected fluid spread beyond the lung parenchyma. Infective complications include parapneumonic pleural effusion progressing to complex effusion and empyema, lung abscess (associated with aspiration and specific organisms), hematogenous spread causing peritonitis/infective arthritis/endocarditis, line-associated cellulitis from intravenous access, and antibiotic-associated Clostridium difficile superinfection of the gut. This is respiratory medicine's framework for anticipating and classifying deterioration or non-resolution during pneumonia treatment.
Severe pneumonia produces two categories of complications: physiological (hypoxia, septic shock, ARDS, renal impairment, deep vein thrombosis, atrial fibrillation, acute cardiac ischemia from physiol…