title: Severe community-acquired pneumonia caused by atypical organisms.
abstract: Three cases of community-acquired pneumonia (CAP), requiring intensive care admission, are presented. The clinical picture of a "typical" bacterial pneumonia in the three patients led to an initial empirical treatment with amoxicillin clavulanic acid or 2(nd) generation cephalosporins. The treatment had to be changed in all three because of clinical failure. Erythromycin was added to the therapy with good clinical evolution. Serology confirmed atypical organisms to be responsible. Only the chest X-ray might have suggested an "atypical" or a "viral-like" agent. A proposition is made for an empirical combination of antibiotics in severely ill patients with CAP with more than unilobar consolidation.
authors.affiliation: Department of Medicine, Academic Hospital (AZ-VUB), Free University of Brussels, Belzium.
authors.forename: I
authors.initials: I
authors.lastname: Monsieur
authors.forename: M
authors.initials: M
authors.lastname: Meysman
authors.forename: W
authors.initials: W
authors.lastname: Vincken
authors.forename: L
authors.initials: L
authors.lastname: Huyghens
authors.forename: S
authors.initials: S
authors.lastname: Lauwers
mesh_terms: D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D019980:Amoxicillin-Potassium Clavulanate Combination; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002444:Cefuroxime / Q000008:administration & dosage / Q000627:therapeutic use; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use; D017291:Clarithromycin / Q000008:administration & dosage / Q000627:therapeutic use; D002969:Clavulanic Acids / Q000008:administration & dosage / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003422:Critical Care; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use; D004917:Erythromycin / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009428:Netilmicin / Q000008:administration & dosage / Q000627:therapeutic use; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D009956:Psittacosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011859:Radiography; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D002969:Clavulanic Acids; D005839:Gentamicins; D009428:Netilmicin; D004917:Erythromycin; D019980:Amoxicillin-Potassium Clavulanate Combination; D000658:Amoxicillin; D017291:Clarithromycin; D002444:Cefuroxime