Are Atypical Pathogens Important for Patients with Community-Acquired Pneumonia?
The term “atypical pathogens” refers to a variety of organisms, including Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella spp., that can cause community-acquired pneumonia (CAP). This designation was developed when investigators realized that some patients with pneumonia had a clinical picture and natural history that differed from that seen in patients with pneumococcal infection. The syndrome, initially associated with M. pneumoniae , is characterized by gradual onset of illness, with low-grade fever, mucoid sputum and a non-toxic presentation, with a chest radiograph that shows more severe involvement than indicated by the patient’s findings. Over the years, the frequency of pneumonia due to atypical pathogens has been widely variable in clinical series, the need for therapy of these pathogens has been questioned, the role of these organisms in severe ICU-treated CAP has been controversial, and the definition of the patient most at risk has been uncertain. In addition, there has been debate about whether identifying the presence of the “atypical pneumonia syndrome” has any diagnostic value and whether clinicians should use the presence or absence of this syndrome to guide initial empiric antibiotic therapy of CAP [2–4].
KeywordsMixed Infection American Thoracic Society Pneumococcal Pneumonia Pneumococcal Infection Comorbid Illness
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- 1.Chanock RM, Hayflick L, Barile MF (1961) Growth on artificial medium of an agent associated with atypical pneumonia and its identification as a PPLO. Proc Natl Acad Sci USA 478: 41Google Scholar
- 4.Niederman MS, Bass JB, Campbell GD, Fein AM, Grossman RF, Mandell LA, Marrie TJ, Sarosi GA, Torres A, Yu VL (1993) Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. Am Rev Respir Dis 148: 1418–1426PubMedGoogle Scholar
- 14.Gordon GS, Throop D, Berberian L, Niederman M, Bass J, Alemayehu D, Mellis S (1996) Validation of the therapeutic recommendations of the American Thoracic Society (ATS) guidelines for community-acquired pneumonia in hospitalized patients. Chest 110: 55S jGoogle Scholar