Atypical Pneumonia: Clinical Observations
Author: mzPOTTER
That is, when pneumonia is diagnosed based on a compatible clinical and condensation on the chest radiograph, it must make a comprehensive medical history for risk factors for particular bacteria, and an assessment of severity in relation of the above mentioned age, comorbidities, length, etc..
The patient can be treated on an outpatient basis, with one or more antibiotics chosen empirically, without doing further research (but with a follow up to 48 hours) or require hospital admission and make a multitude of research and analysis, trying to identify the seed as soon as possible. This identification allows to establish the most appropriate antibiotic treatment to the case (blood, sputum culture, sexology, trastorácicas punctures, bronchoscopy with protected catheter, lung biopsies, etc.).
Atypical Pneumonia
In the fifties, a number of clinical observations drew attention to certain clinical conditions, characterized by:
- One or two days before the onset of high fever, minor symptoms are headache, sore throat, ear pain, irritative cough.
- In the chest radiograph, the lesions were not so much condensation as pneumococcal pneumonia, but rather diffuse lesions, ill-defined.
- Rarely had cough, and sputum was not purulent.
- No germs were isolated.
- Do not respond to antibiotics used to treat pneumococcal pneumonia.
With the improvement of microbiological techniques, were identifying a number of bacteria responsible for these clinical and epidemiological features some of which helped to suspect these diagnoses. Such bacteria are:
- Mycoplasma pneumoniae. It occurs in younger individuals and in small outbreaks. It is characterized by a bad cough 1 or 2 days before and characteristic lesions leads to the eardrum.
- The Coxiella burnetii. Introduces changes in liver function tests. High fever, but well tolerated. It is typical after contact with cattle.
- Chlamydia pneumoniae, which is typical after contact with birds, parakeets, parrots, etc..
- The Legionella pneumophila, which is responsible for Legionnaires’ disease. It is present in showerheads and areas where hot water to form aerosols (cooling towers, etc.)..
The virus pneumonia, rare, have similar clinical features. Unfortunately, clinical experience has shown that clinical and radiological pictures of pneumococcal pneumonia or atypical bacteria have much overlap, so it is impossible to predict the germ responsible for pneumonia only on clinical or radiological, and it is necessary to use microbiological and serological analysis as necessary to identify the causative agent. This is the cause of atypical pneumonia that the term comes falling into disuse, because no information on the prognosis of the disease or help the clinician to make decisions about which analysis to apply or which antibiotic to choose.