Update 1989 pp 110-114 | Cite as

Atypical Pneumonia in the ICU

  • R. J. M. Strack van Schijndel
  • L. G. Thijs
  • J. M. de Vries
Conference paper
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 8)


Severe pulmonary infections with respiratory failure are a common feature in the ICU either as a primary reason for admission or as a complication. In many cases bacterial causes can readily be identified. When Gram stains of pulmonary secretions reveal many leukocytes without bacteria the presence of atypical pneumonia should be considered. This rather outdated but common term is used for pulmonary infiltrative infections caused by Legionella pneumophila, Mycoplasma pneumoniae, Chlamydia psittaci, Coxiella burneti, (para)influenza virus, adenovirus and several other micro-organisms. Not much is known about the incidence of atypical pneumonias in the ICU. Sporadic cases of atypical pneumonia are not rare and may give rise to such severe complications that intensive treatment is necessary. They usually cause diagnostic confusion and initial therapeutic anxiety also because extrapulmonary manifestation may be the most impressive presenting symptoms. In the following, infections due to Mycoplasma pneumoniae and Legionella Pneumophilia will be briefly discussed.


Acute Pancreatitis Adult Respiratory Distress Syndrome Mycoplasma Pneumoniae Atypical Pneumonia Mycoplasma Pneumonia 
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.


  1. 1.
    Cassell GH, Cole BC (1981) Mycoplasmas as agents of human disease. N Engl J Med 304:80–89PubMedCrossRefGoogle Scholar
  2. 2.
    Murray HW, Masur H, Senterfit LB, Roberts RB (1975) The protean manifestations of Mycoplasma pneumoniae infection in adults. Am J Med 58:229–242PubMedCrossRefGoogle Scholar
  3. 3.
    Koletsky RJ, Weinstein AJ (1980) Fulminant Mycoplasma pneumoniae infection. Am Rev Respir Dis 122:491–496PubMedGoogle Scholar
  4. 4.
    Fischman RA, Marschall KE, Kislak JW, Greenbaum DM (1978) Adult respiratory distress syndrome caused by Mycoplasma pneumoniae. Chest 74:471–473PubMedCrossRefGoogle Scholar
  5. 5.
    Jastremski MS (1979) Adult respiratory distress syndrome due to Mycoplasma pneumoniae. Chest 75:529 (letter)PubMedCrossRefGoogle Scholar
  6. 6.
    Höltermann W, Knoch M, Müller W, Lennartz H (1987) ARDS bei Mykoplasmenpneumonie. Anästh Intensivther Notfall Med 22:191–193CrossRefGoogle Scholar
  7. 7.
    Kaufman JM, Cuvelier CA, Van der Straeten M (1980) Mycoplasma pneumonia with fulminant evolution into diffuse interstitial fibrosis. Thorax 35:140–144PubMedCrossRefGoogle Scholar
  8. 8.
    Foy HM, Loop J, Clarke ER, Mansy AW, Spence WF, Feigl P, Graystom JT (1973) Radiographic study of Mycoplasma pneumoniae pneumonia. Am Rev Respir Dis 108:469–473PubMedGoogle Scholar
  9. 9.
    Pönkä A (1980) Central nervous system manifestations associated with serologically verified Mycoplasma pneumoniae infection. Scand J Infect Dis 12:175–184PubMedGoogle Scholar
  10. 10.
    Behan PO, Feldman RG, Segerra JM, Draper IT (1986) Neurological aspects of mycoplasmal infection. Acta Neurol Scand 74:314–322PubMedCrossRefGoogle Scholar
  11. 11.
    Conwill DE, Benson Werner S, Dritz SK, et al (1982) Legionellosis. The 1980 San Francisco outbreak. Am Rev Respir Dis 126:666–669PubMedGoogle Scholar
  12. 12.
    Editorial (1983) Waterborne Legionella. Lancet 2:381–383Google Scholar
  13. 13.
    MacFarlane JT, Finch RG, Ward MJ, Macrae AD (1982) Hospital study of adult community-acquired pneumonia. Lancet 2:255–258PubMedCrossRefGoogle Scholar
  14. 14.
    Gump DW, Frank RO, Winn WC, Foster RS Jr, Broome DV, Cherry WB (1979) Legionnaire’s disease in patients with associated serious disease. Ann Intern Med 90:538–542PubMedGoogle Scholar
  15. 15.
    Helms CM, Viner JP, Sturm RH, Renner ED, Johnson W (1979) Comparitive features of pneumococcal, mycoplasmal and legionnaire’s disease pneumonias. Ann Intern Med 90:543–547PubMedGoogle Scholar
  16. 16.
    England ACIII, Fraser DW, Plikaytis BD, Tsai T, Storch G, Broome CV (1981) Sporadic legionellosis in the United States: the first thousand cases. Ann Intern Med 94:164–170PubMedGoogle Scholar
  17. 17.
    Saravolatz LD, Burch KM, Fisher E, Madhavan T, Kiani D, Neblett T, Quinn EL (1979) The compromised host and legionnaire’s disease. Ann Intern Med 90:533–537PubMedGoogle Scholar
  18. 18.
    Tsai TF, Finn DR, Plikaytis BD, McCauley W, Martin SM, Fraser DW (1979) Legionnaire’s disease: clinical features of the epidemic in Philadelphia. Ann Intern Med 90:509–528PubMedGoogle Scholar
  19. 19.
    Miller AC (1979) Early clinical differentation between Legionnaire’s disease and other sporadic pneumonias. Ann Intern Med 90:526–528PubMedGoogle Scholar
  20. 20.
    Venkatachalam KK, Saravolatz LD, Christopher KL (1979) Legionnaire’s disease, a cause of lung abscess. JAMA 241:597–598PubMedCrossRefGoogle Scholar
  21. 21.
    Lewin S, Brettman LR, Goldstein EJC, et al (1979) Legionnaire’s disease: a cause of severe abscess-forming pneumonia. Am J Med 67:339–342PubMedCrossRefGoogle Scholar
  22. 22.
    Meenhorst PL, Van der Meer JWM, Borst J (1979) Sporadic cases of legionnaire’s disease in the Netherlands. Ann Intern Med 90:529–532PubMedGoogle Scholar
  23. 23.
    Hughes JA, Anderson PB (1985) Pulmonary cavitation, fibrosis and Legionnaire’s disease. Eur J Respir Dis 66:59–61PubMedGoogle Scholar
  24. 24.
    Gregory DW, Schaffner W, Alford RH, Kaiser AB, McGee ZA (1979) Sporadic cases of legionnaire’s disease: the expanding clinical spectrum. Ann Intern Med 90:518–521PubMedGoogle Scholar
  25. 25.
    Michel O, Naeije N, Csoma M, Sergysels R, De Coster A (1985) Acute pancreatitis in Legionnaire’s disease. Eur J Respir Dis 66:62–64PubMedGoogle Scholar
  26. 26.
    Monforte R, Estruch R, Vidal J, Cervera R, Urbano-Marquez A (1988) Delayed seroconversion in legionnaire’s disease. Lancet 2:513 (letter)PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • R. J. M. Strack van Schijndel
  • L. G. Thijs
  • J. M. de Vries

There are no affiliations available

Personalised recommendations