Atypical pneumonia. Extrapulmonary clues guide the way to diagnosis.
In atypical pneumonia, causative organisms are difficult to isolate, so careful clinical assessment is essential in arriving at a working diagnosis. Definitive diagnosis through serologic testing is usually retrospective. Either a high initial titer or a fourfold or greater rise between the acute and convalescent titer is considered diagnostic in a patient with compatible illness. Legionella and mycoplasma organisms may be cultured from respiratory secretions if plated on appropriate culture media. Using a syndromic approach, physicians can almost always differentiate typical from atypical community-acquired pneumonia and narrow diagnostic possibilities among the atypical pathogens, making possible institution of early, possibly lifesaving, empirical therapy.
Infectious Disease Division, Winthrop-University Hospital, Mineola, New York, USA.
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Cunha
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Ortega
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002690:Chlamydia Infections / Q000175:diagnosis; D016993:Chlamydophila pneumoniae; D003937:Diagnosis, Differential; D006801:Humans; D007877:Legionnaires' Disease / Q000175:diagnosis; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis; D015047:Zoonoses
D000900:Anti-Bacterial Agents