Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- 29 Acute bronchitis and acute exacerbations of chronic airways disease
- 30 Croup, supraglottitis, and laryngitis
- 31 Atypical pneumonia
- 32 Community-acquired pneumonia
- 33 Nosocomial pneumonia
- 34 Aspiration pneumonia
- 35 Lung abscess
- 36 Empyema and bronchopleural fistula
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
31 - Atypical pneumonia
from Part V - Clinical syndromes: respiratory tract
Published online by Cambridge University Press: 05 April 2015
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- 29 Acute bronchitis and acute exacerbations of chronic airways disease
- 30 Croup, supraglottitis, and laryngitis
- 31 Atypical pneumonia
- 32 Community-acquired pneumonia
- 33 Nosocomial pneumonia
- 34 Aspiration pneumonia
- 35 Lung abscess
- 36 Empyema and bronchopleural fistula
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
Summary
Atypical pneumonia
The term “atypical pneumonia” was first termed over 60 years ago to describe cases of pneumonia caused by an unknown agent(s) and which appeared clinically different from pneumococcal pneumonia. It was initially characterized by constitutional symptoms, often with upper and lower respiratory tract symptoms and signs, a protracted course with gradual resolution, the lack of typical findings of consolidation on chest radiograph, failure to isolate a pathogen on routine bacteriologic methods, and a lack of response to penicillin therapy. In the 1940s an agent that was believed to be the principal cause was identified as Mycoplasma pneumoniae. Subsequently other pathogens have been linked with atypical pneumonia because of similar clinical presentation, including a variety of respiratory viruses, Chlamydia pneumoniae, Chlamydia psittaci, and Coxiella burnettii. Less common etiologic agents associated with atypical pneumonia include Francisella tularensis, Yersinia pestis (plague), and the Sin Nombre virus (hantavirus pulmonary syndrome), although these agents are often associated with a more acute clinical syndrome. In addition, although presently exceedingly rare, inhalation anthrax is included in part because of the concern for this pathogen as an agent of bioterrorism. Finally, pneumonia caused by Legionella species, albeit often more characteristic of pyogenic pneumonia, is also included since it is not isolated using routine microbiologic methods.
Although the original classification of atypical and typical pneumonia arose from the perception that the clinical presentation of patients was different, recent studies have shown there is excessive overlap of clinical manifestations of specific causes which does not permit empiric therapeutic decisions to be made solely on this basis. Thus, the designation of atypical pneumonia is controversial in relation to scientific and clinical merit; and many authorities have suggested that the term “atypical” be discontinued. However, the term remains popular among clinicians and investigators and remains prevalent in recent literature regardless of its clinical value. Moreover, options for appropriate antimicrobial therapy for the most common causes are similar, which is considered justification by some to lump these together.
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- Clinical Infectious Disease , pp. 205 - 213Publisher: Cambridge University PressPrint publication year: 2015