A 72-year-old man is admitted with community-acquired pneumonia. On assessment he is disoriented to time and place, urea is 56 mg/dL, respiratory rate is 28/min, blood pressure is 94/56 mm Hg, and temperature is 38.6 degrees C. Using CURB-65, what is his score and its implication?
- A Score 4, severe pneumonia, assess for ICU care ✓
- B Score 3, requires hospital ward admission
- C Score 2, suitable for outpatient management
- D Score 5, palliative care discussion
Correct answer: A. Score 4, severe pneumonia, assess for ICU care
Explanation
He scores 1 each for Confusion, Urea above 43 mg/dL (about 7 mmol/L), Blood pressure systolic below 90 mm Hg, and age 65 or more; respiratory rate is under 30 so that point is absent, giving a total of 4. C CURB-65 score of 4 or 5 defines severe pneumonia with high mortality and mandates assessment for ICU admission. Scores of 0 to 1 suit outpatient care and 2 to 3 warrant hospitalisation, so options C, B, and D misapply the scoring thresholds.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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Written and medically reviewed by the StethoPrep medical team.