Delayed resolution of pneumonia. When is slow healing too slow?

Slowly resolving or nonresolving pneumonia is a clinical challenge, but we believe it can be dealt with in a rational and decisive manner. The following risk factors have been established for delayed radiographic resolution of pneumonia and should be considered in patient evaluation: Coexisting medical conditions History of smoking, Advanced age, Multilobar involvement, Persistent fever or leukocytosis. Diabetes, chronic obstructive pulmonary disease, renal failure, and alcohol abuse can impair immune function, which slows normal clearing of infiltrates. Common and uncommon infectious agents, conditions that mimic pneumonia (eg, a neoplasm, congestive heart failure), and pulmonary complications (eg, abscess) can also result in delayed resolution.