Abstract
The term and concept of atypical pneumonia appeared in the 1940s following observations of penicillin-resistant pneumonia [1]. Despite the identification of a large number of microorganisms, the challenge of isolating so-called ‘atypical’ bacteria is the principal cause of failure of the etiologic diagnosis of pneumonia. These pathogenic agents in the tracheobronchial tree include a large variety of bacteria, viruses and even protozoa. Among atypical bacteria, Chlamydia pneumoniae, Mycoplasma pneumoniae, Legionella pneumoniae, Bordetella pertussis, and Coxiella burnetii are the most widespread. Numerous other bacteria are emerging pathogenic species whose virulence is currently being evaluated. Clinical examination only provides a diagnostic orientation in a restricted number of cases. The availability of rapid and specific microbiologic examination improves the diagnostic performance for this type of pneumonia (Table 1) [2]. Since most of these bacteria are intracellular, diagnosis is based principally on serology.
Chapter PDF
Similar content being viewed by others
Keywords
- Mycoplasma Pneumoniae
- Elementary Body
- Atypical Pneumonia
- Urinary Antigen
- Acute Disseminate Encephalomyelitis
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
References
Eaton M, Meikeljohn G, Van Herick W (1944) Studies on the etiology of primary atypical pneumonia: A filtrable agent transmissible to cotton rats, hamsters and chick embryos. J Exp Med 79:649–661
Raoult D, Fournier P, Drancourt M (2004) What does the future hold for clinical microbiology? Nat Rev Microbiol 2:151–159
Aubas S, Aubas P, Capdevila X, Darbas H, Roustan J, du Cailar J (1994) Bronchoalveolar lavage for diagnosing bacterial pneumonia in mechanically ventilated patients. Am J Respir Crit Care Med 149:860–866
Rosenstraus M, Wang Z, Chang S, DeBonville D, Spadoro J (1998) An internal control for routine diagnostic PCR: design, properties, and effect on clinical performance. J Clin Microbiol 36:191–197
Edelstein P (1993) Legionnaires’ disease. Clin Infect Dis 16:741–749
Harrison T, Uldum S, Alexiou-Daniel S, et al (1998) A multicenter evaluation of the Biotest legionella urinary antigen EIA. Clin Microbiol Infect 4:359–365
Birtles R, Harrison T, Samuel D, Taylor A (1990) Evaluation of urinary antigen ELISA for diagnosing Legionella pneumophila serogroup 1 infection. J Clin Pathol: 685–690
Bornstein N, Fleurette J (1994) Legionella. In: Freney J, Renaud F, Hansen D, Bollet C (eds) Manuel de Bactériologie Clinique. Elsevier, Paris, pp 1327–1354
Hammerschlag M (2001) Mycoplasma pneumoniae infections. Curr Opin Infect Dis 14:181–186
Reimann H (1984) Landmark article Dec 24,1938: An acute infection of the respiratory tract with atypical pneumonia. A disease entity probably caused by a filtrable virus. By Hobart A. Reimann. JAMA 251:936–944
Parides G, Bloom J, Ampel N, Ray C (1988) Mycoplasma and ureaplasma in bronchoalveolar lavage fluids from immunocompromised hosts. Diagn Microbiol Infect Dis 9:55–57
Sasaki T, Bonissol C, Stoiljkovic B (1987) Cross-reactive antibodies to mycoplasmas found in human sera by the enzyme-linked immunosorbent assay (ELISA). Microbiol Immunol 31:521–530
Bredt W, Kleinmann B, Jacobs E (1987) Antibodies in the sera of Mycoplasma pneumoniae-infected patients against proteins of Mycoplasma genitalium and other mycoplasmas of man. Zentralbl Bakteriol Mikrobiol Hyg 266:32–42
Watkins-Riedel T, Stanek G, Daxboeck F (2001) Comparison of SeroMP IgA with four other commercial assays for serodiagnosis of Mycoplasma pneumoniae pneumonia. Diagn Microbiol Infect Dis 40:21–25
Grayston J, Wang S, Kuo C, Campbell L (1989) Current knowledge on Chlamydia pneumoniae, strain TWAR, an important cause of pneumonia and other acute respiratory diseases. Eur J Clin Microbiol Infect Dis 8:191–202
Danesh J (2005) Antibiotics in the prevention of heart attacks. Lancet 365:365–367
Ramirez J, Ahkee S, Tolentino A, Miller R, Summersgill J (1996) Diagnosis of Legionella pneumophila, Mycoplasma pneumoniae, or Chlamydia pneumoniae lower respiratory infection using the polymerase chain reaction on a single throat swab specimen. Diagn Microbiol Infect Dis 24:7–14
Laudenbach V, Mantz J, Desmonts J (1999) Understanding of molecular biology. Ann Fr Anesth Reanim 18:725–747
Orfila J, Chaigneau C, Gommeux A, Sueur J, Fey T (1995) Epidémiologie des infections respiratoires à Chlamydia Pneumoniae dans le département de la Somme. Bull Epidemiol Hebd 42:186–187
Marston B, Plouffe J, File T, et al (1997) Incidence of community-acquired pneumonia requiring hospitalization. Results of a population-based active surveillance Study in Ohio. The Community-Based Pneumonia Incidence Study Group. Arch Intern Med 157:1709–1718
Tissot Dupont H, Raoult D, Brouqui P, et al (1992) Epidemiologie features and clinical presentation of acute Q fever in hospitalized patients: 323 French cases. Am J Med 93:427–434
Mege J, Maurin M, Capo C, Raoult D (1997) Coxiella burnetii: the ‘query’ fever bacterium. A model of immune subversion by a strictly intracellular microorganism. FEMS Microbiol Rev 19:209–217
Raoult D (1996) Q fever: still a query after all these years. J Med Microbiol 44:77–78
Dupuis G, Petite J, Peter O, Vouilloz M (1987) An important outbreak of human Q fever in a Swiss Alpine valley. Int J Epidemiol 16:282–287
Dupuis G, Peter O, Pedroni D, Petite J (1985) Clinical aspects observed during an epidemic of 415 cases of Q fever. Schweiz Med Wochenschr 115:814–818
Maurin M, Raoult D (1999) Q fever. Clin Microbiol Rev 12:518–553
Leone M, Honstettre A, Lepidi H, et al (2004) Effect of sex on Coxiella burnetii infection: protective role of 17beta-estradiol. J Infect Dis 189:339–345
Derrick E (1937) Q fever, a new fever entity: clinical features, diagnosis and laboratory investigation. Med J Aust 2:281–299
Marrie T (1995) Coxiella burnetii (Q fever) pneumonia. Clin Infect Dis Suppl 3:S253–S264
Fournier P (1999) Fièvre Q In: Bricaire F (ed) Encycl Med Chir, Maladies Infectieuses, Elsevier, Paris, 8-037-1-10
Raoult D, Brouqui P (1993) Intracellular location of microorganisms. In: Raoult D (ed) Antimicrobial Agents and Intracellular Pathogens. CRC Press, Boca Raton, pp 39–62
Hackstadt T, Williams J (1981) Biochemical stratagem for obligate parasitism of eukaryotic cells by Coxiella burnetii. Proc Natl Acad Sci USA 78:3240–3244
Subramanya N, Wright J, Khan M (1982) Failure of rifampicin and co-trimoxazole in Q fever endocarditis. BMJ 285:343–344
Raoult D (1993) Treatment of Q fever. Antimicrob Agents Chemother 37:1733–1736
Marrie T, Raoult D (2002) Update on Q fever, including Q fever endocarditis. Curr Clin Top Infect Dis 22:97–124
Maurin M, Benoliel A, Bongrand P, Raoult D (1992) Phagolysosomal alkalinization and the bactericidal effect of antibiotics: the Coxiella burnetii paradigm. J Infect Dis 166:1097–1102
Raoult D, Drancourt M, Vestris G (1990) Bactericidal effect of doxycycline associated with lysosomotropic agents on Coxiella burnetii in P388D1 cells. Antimicrob Agents Chemother 34:1512–1514
Brundrett G (1992) Legionella and Building Services. Butterworth Heinemann, Oxford.
Greub G, Boyadjiev I, La Scola B, Raoult D, Martin C (2003) Serological hint suggesting that Parachlamydiaceae are agents of pneumonia in polytraumatized intensive care patients. Ann NY Acad Sci 990:311–319
Rowbotham TJ (1980) Preliminary report on the pathogenicity of Legionella pneumophila for freshwater and soil amoebae. J Clin Pathol 33:1179–1183
Kwait Y, Gao L, Stone B, Venkataraman C, Harb O (1998) Invasion of Protozoa by Legionella pneumophila and its role in bacterial ecology and pathogenesis. Appl Environ Microbiol 64:3127–3133
Joshi A, Swanson M (1999) Comparative analysis of Legionella pneumophila and Legionella micdadei virulence traits. Infect Immun 67:4134–4142
Woo A, Goetz A, Yu V (1992) Transmission of Legionella by respiratory equipment and aerosol generating devices. Chest 102:1586–1590
Tokuda H, Yahagi N, Kasai S, Kitamura S, Otsuka Y (1997) A case of fatal pneumonia caused by Legionella pneumophila serogroup 6 developed after drowning in a public bath. Kansenshogaku Zasshi 71:169–174
Mitchell D, Hicks L, Chiew R, Montanaro J, Chen S (1997) Pseudoepidemic of Legionella pneumophila serogroup 6 associated with contaminated bronchoscopes. J Hosp Infect 37:19–23
Rello J, Bodi M, Mariscal D, Navarro M, Diaz E, Gallego M, Valles J (2003) Microbiological testing and outcome of patients with severe community-acquired pneumonia. Chest 123:174–180
Hutchinton O (1990) Nosocomial legionellosis. Rev Med Microbiol 1:108–115
Spieker S, Petersen D, Rolfs A, Fehrenbach F, Kuntz R, Seuffe R (1998) Acute disseminated encephalomyelitis following Pontiac fever. Eur Neurol 40:169–172
Brouqui P, Raoult D (2001) Endocarditis due to rare and fastidious bacteria. Clin Microbiol Rev 14:177–207
Stout J, Yu V (1997) Legionellosis. N Engl J Med 337:682–687
Vandenesch F, Surgot M, Bornstein N, Paucod J, Marmet D, Isoard P (1990) Relationship between free Amoeba and Legionella: studies in vitro and in vivo. Zentralbl Bakteriol 272:265–275
Sile S, Straub T, Christmann B (1994) Manifestations extra-pulmonaires des légionelloses. Med Mal Infect 24:874–880
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2006 Springer Science + Business Media Inc.
About this paper
Cite this paper
Boyadjiev, I., Léone, M., Martin, C. (2006). Acute Pneumonia and Importance of Atypical Bacteria. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/0-387-35096-9_53
Download citation
DOI: https://doi.org/10.1007/0-387-35096-9_53
Publisher Name: Springer, New York, NY
Print ISBN: 978-0-387-30156-3
Online ISBN: 978-0-387-35096-7
eBook Packages: MedicineMedicine (R0)