The management of a community-acquired lower respiratory tract infection (LRTI) should follow a systematic step-by-step process (fig. 1), beginning with a detailed history and clinical examination. Attempts to identify the type of LRTI (pneumonia, acute bronchitis, superinfection of chronic bronchitis, or viral infection) are probably unhelpful outside hospital, since several studies have demonstrated that the sensitivity and specificity of clinical signs and symptoms are low for establishing such a classification. Therefore, the main goal of initial clinical evaluation is to determine whether the patient can be managed at home or whether there is evidence that suggests potential or immediate severity, or that the illness will follow a complicated course (table 1, fig. 2). All these features will guide the decision on hospital referral and admission (fig. 2).