Atypical Pneumonia: Updates on Legionella, Chlamydophila, and Mycoplasma Pneumonia

Overview

Journal Clin Chest Med

Specialty Pulmonary Medicine

Date 2017 Feb 5

PMID 28159161

Citations 31

Authors

Lokesh Sharma

Ashley Losier

Thomas Tolbert

Charles S Dela Cruz

Chad R Marion

Affiliations

Soon will be listed here.

Abstract

Community-acquired pneumonia (CAP) has multiple causes and is associated with illness that requires admission to the hospital and mortality. The causes of atypical CAP include Legionella species, Chlamydophila, and Mycoplasma. Atypical CAP remains a diagnostic challenge and, therefore, likely is undertreated. This article reviews the advancements in the evaluation and treatment of patients and discusses current conflicts and controversies of atypical CAP.

Citing Articles

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References

Lee Y, Chen S, Chan K, Wu T, Tsao S, Chan C . Impact of infectious etiology on the outcome of Taiwanese patients hospitalized with community acquired pneumonia. J Infect Dev Ctries. 2013; 7(2):116-24. DOI: 10.3855/jidc.2834. View

Zhao F, Liu G, Wu J, Cao B, Tao X, He L . Surveillance of macrolide-resistant Mycoplasma pneumoniae in Beijing, China, from 2008 to 2012. Antimicrob Agents Chemother. 2012; 57(3):1521-3. PMC: 3591905. DOI: 10.1128/AAC.02060-12. View

Sztrymf B, Jacobs F, Fichet J, Hamzaoui O, Prat D, Avenel A . [Mycoplasma-related pneumonia: a rare cause of acute respiratory distress syndrome (ARDS) and of potential antibiotic resistance]. Rev Mal Respir. 2013; 30(1):77-80. DOI: 10.1016/j.rmr.2012.06.012. View

Youn Y, Lee K . Mycoplasma pneumoniae pneumonia in children. Korean J Pediatr. 2012; 55(2):42-7. PMC: 3286761. DOI: 10.3345/kjp.2012.55.2.42. View

Borges V, Nunes A, Sampaio D, Vieira L, Machado J, Simoes M . Legionella pneumophila strain associated with the first evidence of person-to-person transmission of Legionnaires' disease: a unique mosaic genetic backbone. Sci Rep. 2016; 6:26261. PMC: 4872527. DOI: 10.1038/srep26261. View

Bunk S, Susnea I, Rupp J, Summersgill J, Maass M, Stegmann W . Immunoproteomic identification and serological responses to novel Chlamydia pneumoniae antigens that are associated with persistent C. pneumoniae infections. J Immunol. 2008; 180(8):5490-8. DOI: 10.4049/jimmunol.180.8.5490. View

Lemaire S, Van Bambeke F, Tulkens P . Activity of finafloxacin, a novel fluoroquinolone with increased activity at acid pH, towards extracellular and intracellular Staphylococcus aureus, Listeria monocytogenes and Legionella pneumophila. Int J Antimicrob Agents. 2011; 38(1):52-9. DOI: 10.1016/j.ijantimicag.2011.03.002. View

Dorrell L, Fulton B, Ong E . Intravenous azithromycin as salvage therapy in a patient with Legionnaire's disease. Thorax. 1994; 49(6):620-1. PMC: 474972. DOI: 10.1136/thx.49.6.620. View

Saikku P, Leinonen M, Mattila K, Ekman M, Nieminen M, Makela P . Serological evidence of an association of a novel Chlamydia, TWAR, with chronic coronary heart disease and acute myocardial infarction. Lancet. 1988; 2(8618):983-6. DOI: 10.1016/s0140-6736(88)90741-6. View

10.

Cao B, Zhao C, Yin Y, Zhao F, Song S, Bai L . High prevalence of macrolide resistance in Mycoplasma pneumoniae isolates from adult and adolescent patients with respiratory tract infection in China. Clin Infect Dis. 2010; 51(2):189-94. DOI: 10.1086/653535. View

11.

Jain S, Self W, Wunderink R . Community-Acquired Pneumonia Requiring Hospitalization. N Engl J Med. 2015; 373(24):2382. PMC: 9338768. DOI: 10.1056/NEJMc1511751. View

12.

Puolakkainen M . Laboratory diagnosis of persistent human chlamydial infection. Front Cell Infect Microbiol. 2014; 3:99. PMC: 3865385. DOI: 10.3389/fcimb.2013.00099. View

13.

Zheng X, Lee S, Selvarangan R, Qin X, Tang Y, Stiles J . Macrolide-Resistant Mycoplasma pneumoniae, United States. Emerg Infect Dis. 2015; 21(8):1470-2. PMC: 4517703. DOI: 10.3201/eid2108.150273. View

14.

Chotikanatis K, Kohlhoff S, Hammerschlag M . In vitro activity of nemonoxacin, a novel nonfluorinated quinolone antibiotic, against Chlamydia trachomatis and Chlamydia pneumoniae. Antimicrob Agents Chemother. 2013; 58(3):1800-1. PMC: 3957896. DOI: 10.1128/AAC.02263-13. View

15.

Gacouin A, Le Tulzo Y, Lavoue S, Camus C, Hoff J, Bassen R . Severe pneumonia due to Legionella pneumophila: prognostic factors, impact of delayed appropriate antimicrobial therapy. Intensive Care Med. 2002; 28(6):686-91. DOI: 10.1007/s00134-002-1304-8. View

16.

Hoymans V, Bosmans J, Ieven M, Vrints C . Chlamydia pneumoniae-based atherosclerosis: a smoking gun. Acta Cardiol. 2008; 62(6):565-71. DOI: 10.2143/AC.62.6.2024015. View

17.

Biedenbach D, Huband M, Hackel M, de Jonge B, Sahm D, Bradford P . In Vitro Activity of AZD0914, a Novel Bacterial DNA Gyrase/Topoisomerase IV Inhibitor, against Clinically Relevant Gram-Positive and Fastidious Gram-Negative Pathogens. Antimicrob Agents Chemother. 2015; 59(10):6053-63. PMC: 4576048. DOI: 10.1128/AAC.01016-15. View

18.

Fisman D, Lim S, Wellenius G, Johnson C, Britz P, Gaskins M . It's not the heat, it's the humidity: wet weather increases legionellosis risk in the greater Philadelphia metropolitan area. J Infect Dis. 2005; 192(12):2066-73. DOI: 10.1086/498248. View

19.

Fields B, Benson R, Besser R . Legionella and Legionnaires' disease: 25 years of investigation. Clin Microbiol Rev. 2002; 15(3):506-26. PMC: 118082. DOI: 10.1128/CMR.15.3.506-526.2002. View

20.

Lettinga K, Verbon A, Nieuwkerk P, Jonkers R, Gersons B, Prins J . Health-related quality of life and posttraumatic stress disorder among survivors of an outbreak of Legionnaires disease. Clin Infect Dis. 2002; 35(1):11-7. DOI: 10.1086/340738. View