ATYPICAL PATHOGENS IN COMMUNITY-ACQUIRED PNEUMONIA - 08/09/11

Doi : 10.1016/S0272-5231(05)70230-6

David Lieberman, MD ^{^{*
Division of Health Sciences, Ben-Gurion University of the Negev; and the Pulmonology Unit, Soroka Medical Center, Beer-Sheva, Israel}}

Résumé

“Atypical pathogens”are a group of respiratory pathogens that cause clinical manifestations of many diseases, including community-acquired pneumonia (CAP). In accordance with the original use of the term, the “atypical pathogen” group includes Mycoplasma pneumoniae; various Legionella spp; Chlamydia pneumoniae; Coxiella burnettii (which causes Q-fever); and the respiratory viruses, especially influenza A and B, parainfluenza 1, 2, and 3, respiratory syncytial virus (RSV), and Epstein-Barr virus (EBV). The group also includes uncommon pathogens such as tularemia^{17 Fredricks D.N., Remington J.S. Tularemia presenting as community-acquired pneumonia. Implications in the era of managed care Arch Intern Med 1996 ; 156 : 2137-2140

Cliquez ici pour aller à la section Références} and Leptospira,^{27 Lawrence I.G., Dalby R.J., Lad N.R. , et al. An atypical case of atypical pneumonia Br J Clin Prac 1996 ; 50 : 346-348

Cliquez ici pour aller à la section Références, 65 Teglia O.F., Battagliotti C., Villavicencio R.L. , et al. Leptospiral pneumonia Chest 1995 ; 108 : 874-875 [cross-ref]

Cliquez ici pour aller à la section Références} as well as the group of viruses that causes the hantavirus pulmonary syndrome.^{39 MMWR Hantavirus pulmonary syndrome-United States, 1995 and 1996 JAMA 1996 ; 275 : 1395-1397

Cliquez ici pour aller à la section Références} Serological evidence recently was reported that a new chlamydia-like pathogen termed Z can cause CAP^{30 Lieberman D. Kahane S., Lieberman D. , et al. Pneumonia with serological evidence of acute infection with the Chlamydia-like microorganism “Z” Am J Respir Crit Care Med 1997 ; 156 : 578-582

Cliquez ici pour aller à la section Références} and should be included in the list of atypical pathogens. Because this list of pathogens is getting long and unwieldy, a tendency lately has developed in the literature to use the term atypical pathogens in a more restricted manner. In this more limited approach, the term includes only M. pneumoniae, C. pneumoniae, and the Legionella spp. This group of pathogens has a common microbiologic characteristic in that they are intracellular bacteria (C. pneumoniae only is an obligatory intracellular pathogen). To focus this review on the principal pathogens, the authors apply the restricted use of the term atypical pathogens and limit the discussion to M. pneumoniae, C. pneumoniae, and Legionella spp.