Pneumonia atypical

A new coronavirus was quickly identified after the outbreak of an atypical pneumonia in southern China early in 2003. The new virus eventually caused 8,000 infections with approximately 800 deaths in 29 countries. The condition was named Severe Acute Respiratory Syndrome, SARS, and the causative coronavirus named SARS-CoV. The zoonotic nature of the infection came with the identification of a similar virus in bats (Poon et al. 2005), although it is possible that the bat virus passed through other animal hosts and recombined with other SARS-like coron-aviruses prior to infecting humans (Hon et al. 2008). SARS-CoV is not currently circulating in the human population however, the mysterious appearance and rapid spread of this virus emphasized how vulnerable the human population is to such respiratory infections. This has spurred interest in the development of antivirals that could be used either in treatment or as prophylaxis to complement public health measures in curbing future outbreaks. 

Suggested Alternatives for Differential Diagnosis Brucellosis, chlamydial pneumonias, infective endocarditis, legionnaires disease, mycoplasma infections, pneumonia, Cox-iella burnetii infection, Francisella tularensis infection, Q fever, tuberculosis, tularemia, typhoid fever, and all atypical pneumonia. 

Suggested Alternatives for Differential Diagnosis Drug induced noncardiac pulmonary edema, acute respiratory distress syndrome, atypical pneumonias, and viral influenza. Mortality Rate (untreated) <15%. 

Diagnosis Q fever is not a clinically distinct illness and may resemble a viral illness or other types of atypical pneumonia. The diagnosis is confirmed serologically. As for treatment, Q fever is generally a self-limiting illness even without treatment. Tetracycline or doxycycline are the treatments of choice and are given orally for five to seven days. Q fever endocarditus, which is rare, is much more difficult to treat. 

Differential Diagnosis Q fever usually presents as an undifferentiated febrile illness, or a primary atypical pneumonia, which must be differentiated from pneumonia caused by mycoplasm, Tegionnaires disease, psittacosis or Chlamydia pneumoniae. More rapidly progressive forms of pneumonia may look like bacterial pneumonia including tularemia or plague. 

Field First Aid In a terrorist attack with Q fever, the primary threat is dissemination of aerosol, or contamination of food. Acute Q fever can appear to develop as an undifferentiated febrile illness, as an atypical pneumonia, or as a rapidly progressive pneumonia. 

Inpus erythematosus A chronic inflammatory disease of connective tissue, affecting the skin and internal organs, lymphoma A malignant tumor of the lymph nodes, multiple sclerosis A disease of the nervous system, myelodysplasia Abnormal or defective formation of the bone marrow. Mycoplasma Minute primitive bacteria without a rigid cell wall. Mycoplasma pneumoniae causes atypical pneumonia in humans, myeloma cells Malignant tumor cells. 

In half the cases of acute community-acquired pneumonia a microbiological diagnosis can be made. Streptococcus pneumoniae is responsible for 16-60% of the cases. The second most prevalent micro-organisms are those responsible for the so called atypical pneumonia syndrome including... 

Levofloxacin, gatifloxacin, gemifloxacin, and moxifloxacin, so-called respiratory fluoroquinolones, with their enhanced gram-positive activity and activity against atypical pneumonia agents (eg, chlamydia, mycoplasma, and legionella), are effective and used increasingly for treatment of upper and lower respiratory tract infections. 

For example, Mycoplasma pneumoniae is responsible for primary atypical pneumonia. 

Mycoplasma pneumoniae Atypical pneumonia Azithromycin, clarithromycin, or erythromycin Doxycycline or a fluoroquinolone... 

The risk of addiction is greater in the case of dihydrocodeinone than with codeine, but small doses (5 to 10 mg) are often of value in tuberculosis, measles, atypical pneumonia, etc., conditions in which cough is a troublesome symptom. 

Tetracyclines are classified as broad-spectrum antibiotics obtained from soil acti-nomycetes. All tetracyclines are slightly bitter solids and are weakly soluble in water. Although tetracyclines develop organism resistance, they are the drugs of first choice in venereal disease, atypical pneumonia, cholera, brucellosis, and plague. Tetracyclines also are used in urinary tract infections, amebiasis, acne, and as prophylaxis against meningitis. 

Given its rarity, physicians and hospital laboratorians have a low index of suspicion for tularemia infection. Because of the nonspecific symptoms and absence of radiographic findings, physicians and public health authorities would have difficulty distinguishing between a terrorist attack involving tularemia and a natural outbreak of community acquired infection, especially influenza and some atypical pneumonias (43). Several epidemiologic clues that might indicate an intentional cause would include (43) ... 

An unusual proportion of patients with signs of atypical pneumonia, pleuritis, and hilar adenopathy... 

SARS (severe acute respiratory syndrome) is an atypical pneumonia caused by a coronavirus. 

Viruses, Mycoplasma spp., Chlamydia spp., and fungi are recognized causes of pneumonia syndromes in all age groups. The designation atypical pneumonia, distinct from the typical bacterial pneumonia seen most commonly in adults, has been used to describe the illness caused by many of these agents. " ... 

Mycoplasma pneumoniae Atypical pneumonia More sensitive than culture B2... 

Minute primitive bacteria without a rigid cell wall. Mycoplasma pneumoniae causes atypical pneumonia in humans. 

Schonwald, S., Barsic, B., Klinar, I., and Gunjaca, M. (1994). Three-day azithromycin compared with ten-day roxithromycin treatment of atypical pneumonia. Scand. J. Infect. Dis. 26, 706-710. 

Mycoplasma Infections Mycoplasma pneumoniae is sensitive to tetracychnes, which shorten the duration of chnical manifestations in atypical pneumonia. 

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