II. Epidemiology
- Highest Incidence among elderly
- Nursing Home epidemics have recently been identified
- Reference
- Also common in young adults
- Causes 6-10% of Community Acquired Pneumonia
- Higher risk with comrobid illness
III. Pathophysiology
- Organism
- Chlamydophila pneumoniae (Chlamydia pneumoniae, TWAR)
- TWAR is an acronym for "Taiwan and Acute Respiratory"
- Contrast with Neonatal Chlamydia Pneumonia
- Caused by the STI Chlamydia Trachomatis via vertical transmission in newborns
IV. Findings: Presentations
-
Atypical Pneumonia (primary association and the one described on this page)
- Similar to Mycoplasma pneumoniae
- Other presentations
V. Findings: Symptoms and Signs
- Cough (88%): Minimally productive if at all
- Fever (80%)
- Shortness of Breath (73%)
- Chills (73%)
- Nausea (73%
- Headache (56%)
- Myalgia (50%)
- Chest Pain (46%)
- Rhinitis (46%)
- Diarrhea (42%)
- Sore Throat (42%)
- Hoarseness (36%)
VI. Labs
- Chlamydia Serologies
-
Complete Blood Count
- Mild Leukocytosis
VII. Imaging
-
Chest XRay
- Localized segmental infiltrate in Atypical Pneumonia
VIII. Management: Antibiotic for 10 to 14 days
- Primary
- Doxycycline 100 mg orally or IV for 14 days OR
- Azithromycin 500 mg orally on day 1, then 250 mg orally daily on Days 2 to 5
- Alternative Antibiotics
- Levofloxacin 750 mg orally or IV for 5 to 7 days
- Erythromycin or Clarithromycin
- Fluoroquinolone
IX. Prognosis
- Mortality may approach 9% in edlerly with comorbidity
X. References
- Gilbert (2001) Sanford Antimicrobial, p. 28
- File (1998) Infect Dis Clin North Am 12(3):569-92 [PubMed]
- File (1999) Clin Infect Dis 29:426-8 [PubMed]
- Grayston (1992) Annu Rev Med 43:317-23 [PubMed]
- Kuo (1995) Clin Microbiol Rev 8(4):451-61 [PubMed]
- Plouffe (2000) Clin Infect Dis 31:S35-9 [PubMed]
- Tan (1999) Can Respir J 6:15A-9A [PubMed]
- Choroszy-Król (2014) Adv Clin Exp Med 23(1):123-6 +PMID: 24596014 [PubMed]
