Atypical pneumonia

Classification according to ICD-10
J18.8	Other pneumonia, pathogen unspecified
A48.1	Legionnaires' disease (Legionella pneumonia)
J15.7	Pneumonia due to Mycoplasma pneumoniae
J16.0	Chlamydial pneumonia
ICD-10 online (WHO version 2019)

The Atypical pneumonia is from the "typical" pneumonia, usually a lobar pneumonia , distinguished. The term itself can refer to the pathogen , but if used imprecisely, it can also refer to the course of an unexplained pneumonia. A distinction is made between viral , typical and atypical pathogens that cause pneumonia. According to the current nomenclature, virus pneumonia is not counted as an atypical pneumonia. Regarding the pneumonias are these distinctions in the case of community-acquired pneumonia ( community-acquired pneumonia ( CAP made)), the pneumonia that was not only in the hospital or acquired secondary. Atypical legionella pneumonia can be particularly severe.

Epidemiology

Atypical pneumonia is more common in spring and summer and in males under 60 without COPD . Mycoplasma and chlamydia are more common in young adults. Approximately 15% of all CAPs are atypical pneumonia, they occur sporadically.

The causative agents of atypical pneumonia are (partly zoonoses ):

Legionella , Mycoplasma pneumoniae , Chlamydia , Pneumocystis jirovecii , Coxiella burnetii , Francisella tularensis

In contrast, the pathogens causing "typical" pneumonia are:

Streptococcus pneumoniae , Haemophilus influenzae , Moraxella catarrhalis

diagnosis

The diagnosis is made more difficult by the fact that the findings and the course can be varied. The x-ray of classic lobar pneumonia shows an infiltrate that is approximately limited to a lung lobe , the x-ray of atypical pneumonia can show bilateral, rapidly changing infiltrates. Atypical pneumonias tend to be accompanied by complications in other organ systems, for example heart problems or disorders of bowel function. (Confusion can occur in all forms of pneumonia, including lobar pneumonia.) If atypical pathogens are detected, pneumonia can be confirmed as atypical pneumonia.

therapy

Some antibiotics do not work properly for atypical pneumonia. Can be effective:

Macrolides , Tetracyclines , Ketolides , Quinolone Antibiotics

Individual evidence

↑ Vivian M. Raeven, Simone MC Spoorenberg u. a .: Atypical aetiology in patients hospitalized with community-acquired pneumonia is associated with age, gender and season; a data analysis on four Dutch cohorts. In: BMC Infectious Diseases. 16, 2016, doi : 10.1186 / s12879-016-1641-9 .
↑ N. Eliakim-Raz, E. Robenshtok, D. Shefet, A. Gafter-Gvili, L. Vidal, M. Paul, L. Leibovici: Empiric antibiotic coverage of atypical pathogens for community-acquired pneumonia in hospitalized adults. In: The Cochrane database of systematic reviews. Number 9, September 2012, p. CD004418, doi : 10.1002 / 14651858.CD004418.pub4 , PMID 22972070 (Review).
↑ If there is a justified suspicion of atypical pneumonia, treat it in two ways! In: Pneumo News. 8, 2016, p. 29, doi : 10.1007 / s15033-016-0575-7 .

[1] Vivian M. Raeven, Simone MC Spoorenberg u. a .: Atypical aetiology in patients hospitalized with community-acquired pneumonia is associated with age, gender and season; a data analysis on four Dutch cohorts. In: BMC Infectious Diseases. 16, 2016, doi : 10.1186 / s12879-016-1641-9 .

[2] N. Eliakim-Raz, E. Robenshtok, D. Shefet, A. Gafter-Gvili, L. Vidal, M. Paul, L. Leibovici: Empiric antibiotic coverage of atypical pathogens for community-acquired pneumonia in hospitalized adults. In: The Cochrane database of systematic reviews. Number 9, September 2012, p. CD004418, doi : 10.1002 / 14651858.CD004418.pub4 , PMID 22972070 (Review).

[3] If there is a justified suspicion of atypical pneumonia, treat it in two ways! In: Pneumo News. 8, 2016, p. 29, doi : 10.1007 / s15033-016-0575-7 .