Pulmonology Book

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Chlamydia Pneumonia

Aka: Chlamydia Pneumonia, Chlamydophila pneumoniae, Chlamydia pneumoniae, TWAR
  1. See Also
    1. Bacterial Pneumonia
    2. Neonatal Chlamydia Pneumonia
  2. Epidemiology
    1. Highest Incidence among elderly
      1. Nursing Home epidemics have recently been identified
      2. Reference
        1. Troy (1997) JAMA 277:1214-8 [PubMed]
    2. Also common in young adults
    3. Causes 6-10% of Community Acquired Pneumonia
    4. Higher risk with comrobid illness
  3. Pathophysiology
    1. Caused by Chlamydophila pneumoniae (Chlamydia pneumoniae, TWAR)
    2. Contrast with Neonatal Chlamydia Pneumonia caused by Chlamydia trachomatis via vertical transmission in newborns
  4. Symptoms
    1. Atypical Pneumonia presentation
      1. Similar to Mycoplasma pneumoniae
    2. Cough (88%): Minimally productive if at all
    3. Fever (80%)
    4. Shortness of Breath (73%)
    5. Chills (73%)
    6. Nausea (73%
    7. Headache (56%)
    8. Myalgia (50%)
    9. Chest Pain (46%)
    10. Rhinitis (46%)
    11. Diarrhea (42%)
    12. Sore Throat (42%)
    13. Hoarseness (36%)
  5. Labs
    1. Chlamydia Serologies
    2. Complete Blood Count
      1. Mild Leukocytosis
  6. Radiology: Chest XRay
    1. Localized segmental infiltrate
  7. Management: Antibiotic for 10 to 14 days
    1. Primary
      1. Doxycycline
    2. Alternative antibiotics
      1. Erythromycin, Azithromycin or Clarithromycin
      2. Fluoroquinolone
  8. Prognosis
    1. Mortality may approach 9% in edlerly with comorbidity
  9. References
    1. Gilbert (2001) Sanford Antimicrobial, p. 28
    2. File (1998) Infect Dis Clin North Am 12(3):569-92 [PubMed]
    3. File (1999) Clin Infect Dis 29:426-8 [PubMed]
    4. Grayston (1992) Annu Rev Med 43:317-23 [PubMed]
    5. Kuo (1995) Clin Microbiol Rev 8(4):451-61 [PubMed]
    6. Plouffe (2000) Clin Infect Dis 31:S35-9 [PubMed]
    7. Tan (1999) Can Respir J 6:15A-9A [PubMed]

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