Community-acquired pneumonia (CAP) severity is assessed using CURB-65. A 70-year-old patient has confusion, urea 8.5 mmol/L, respiratory rate 32/min, BP 88/60 mmHg, and age 70. What is the CURB-65 score and recommended site of care?
- A Score 2 — suitable for outpatient treatment
- B Score 4 — consider ICU admission
- C Score 5 — high severity, ICU admission ✓
- D Score 3 — hospital admission, consider ICU
Correct answer: C. Score 5 — high severity, ICU admission
Explanation
CURB-65 assigns 1 point each for: Confusion (new onset), Urea >7 mmol/L, Respiratory rate ≥30/min, Blood pressure systolic <90 or diastolic ≤60 mmHg, and age ≥65 years. This patient scores 5/5 (all criteria met: confusion, urea 8.5, RR 32, BP 88/60, age 70). A score of 5 carries ~27% 30-day mortality, indicating high severity requiring ICU-level care. Score 0–1: outpatient; score 2: hospital; score 3–5: severe CAP requiring ICU consideration.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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