Nosocomial pneumonia.

Nosocomial pneumonias are a particularly problematic group of infections. The pathogenesis of these pneumonias, including mechanisms of colonization and pulmonary defense mechanisms, is discussed. An approach to the hospitalized patient with fever and infiltrates, based on the clinical setting, the nature of the host defense defect, the radiographic findings, and the results of invasive diagnostic procedures, is presented. Antimicrobial agents available to treat patients with nosocomial pneumonia are reviewed.