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Diagnosis and management of atypical pneumonia 

Diagnosis and management of atypical pneumonia
Diagnosis and management of atypical pneumonia

Martin Langer

and Edoardo Carretto

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date: 25 February 2020

‘Atypical pneumonia’ is an old, but successful term, which covers respiratory infections caused by different micro-organisms, causing similar clinical symptoms, and characterized by similar antimicrobial sensitivity/resistance. Out of specific epidemic contexts, Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumonia are the micro-organisms involved, L. pneumophila being by far the most frequently involved in severe community-acquired ‘atypical’ pneumonia. It is important to suspect ‘atypical’ pneumonia on the basis of clinical presentation and the correlated extrapulmonary symptoms. Knowledge of symptoms leads to suspicion and, consequently, to timely and adequate empiric treatment and proper diagnostic work-up. Standard microbiological diagnosis is based on urinary antigen test for L. pneumophila and on serology for the other pathogens. A culture should be performed if legionellosis is suspected. NATs techniques could be the future diagnostic tests. Close collaboration with the microbiologist will improve the diagnosis.

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