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Atypical pneumonia

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  • Обзор
  • Теория
  • Диагноз
  • Лечение
  • Последующее наблюдение
  • Источники
Последний просмотренный: 8 Aug 2025
Last updated: 10 Sep 2024

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • age <50 years
  • persistent cough
  • dry cough
  • long duration of symptoms
Полная информация

Другие диагностические факторы

  • recent community exposure
  • throat involvement
  • fever
  • headache
  • diarrhea
  • bullous myringitis
  • lung rales/crepitations
  • rash
Полная информация

Факторы риска

  • close community settings
  • immunosuppression
  • cigarette smoking
  • chronic lung disease
  • travel
  • male sex
  • immunomodulating drugs
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • oxygen saturation in air
  • WBC count
  • hemoglobin
  • Liver function tests (LFTs)
  • BUN level
  • real-time reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2
  • chest x-ray
Полная информация

Исследования, проведение которых нужно рассмотреть

  • urinary Legionella antigen
  • sputum culture
  • molecular diagnosis of Mycoplasma pneumoniae or Chlamydophila pneumoniae
  • nasopharyngeal PCR
Полная информация

Алгоритм лечения

Острый

presumed atypical bacterial pneumonia: nonpregnant adult

presumed atypical bacterial pneumonia: pregnant or child

Составители

Авторы

Lorenzo Di Francesco, MD, SFHM, FACP
Lorenzo Di Francesco

Professor of Medicine

Department of Medicine

Division of General Internal Medicine

Emory University School of Medicine

GA

Раскрытие информации

LDF is a Gen Medicine/Point of Care Editorial Board Member for ClinicalKey.

Рецензенты

Mark Woodhead, BSc, DM, FRCP

Honorary Senior Lecturer (University of Manchester)

Consultant in General & Respiratory Medicine

Department of Respiratory Medicine

Manchester Royal Infirmary

Manchester

UK

Раскрытие информации

MW is an author of a reference cited in this topic.

Ethan Rubinstein, MD

H.E. Sellers Research Chair in Infectious Diseases

Head

Section of Adult Infectious Diseases

Department of Internal Medicine

Department of Medical Microbiology

University of Manitoba

Winnipeg

Canada

Раскрытие информации

At the time of the peer review, Professor Rubinstein declared no competing interests. We were made aware that Professor Rubinstein is now deceased.

George L. Anesi, MD, MSCE, MBE

​Assistant Professor

Medicine, Division of Pulmonary, Allergy, and Critical Care

Perelman School of Medicine

University of Pennsylvania

PA

Раскрытие информации

GLA receives research funding from the National Institutes of Health (K23HL161353), the CDC Foundation, the Society of Critical Care Medicine (SCCM), and the University of Pennsylvania Perelman School of Medicine Thomas B. McCabe and Jeannette E. Laws McCabe Fund. GLA reports payments for authoring chapters for UpToDate and for expert witness consulting, including involving COVID-19, and reports that his spouse is employed by the U.S. Food and Drug Administration (FDA).

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia: an official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-67.Полный текст  Аннотация

Lim WS, Baudouin SV, George RC, et al; Pneumonia Guidelines Committee of the BTS Standards of Care Committee. BTS guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009 Oct;64 Suppl 3:iii1-55.Полный текст  Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • Отличия

    • Coronavirus disease 2019 (COVID-19)
    • Typical bacterial pneumonia
    • Viral pneumonia
    Больше Отличия

  • Рекомендации

    • Diagnosis and treatment of adults with community-acquired pneumonia
    • Guidelines for the management of community acquired pneumonia in adults
    Больше Рекомендации

  • Лифлеты для пациента

    Pneumonia

    Больше Лифлеты для пациента

  • Калькуляторы

    Community-acquired pneumonia severity index (PSI) for adults

    CURB-65 pneumonia severity score

    Больше Калькуляторы

  • Videos

    Tracheal intubation: animated demonstration

    Bag-valve-mask ventilation: animated demonstration

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