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Concept
Atypical pneumonia
Summary
Atypical pneumonia, also known as walking pneumonia, is any type of pneumonia not caused by one of the pathogens most commonly associated with the disease. Its clinical presentation contrasts to that of "typical" pneumonia. A variety of microorganisms can cause it. When it develops independently from another disease, it is called primary atypical pneumonia (PAP).
The term was introduced in the 1930s and was contrasted with the bacterial pneumonia caused by Streptococcus pneumoniae, at that time the best known and most commonly occurring form of pneumonia. The distinction was historically considered important, as it differentiated those more likely to present with "typical" respiratory symptoms and lobar pneumonia from those more likely to present with "atypical" generalized symptoms (such as fever, headache, sweating and myalgia) and bronchopneumonia.
Usually the atypical causes also involve atypical symptoms:
No response to common antibiotics such as sulfonamide and beta-lactams like penicillin.
No signs and symptoms of lobar consolidation, meaning that the infection is restricted to small areas, rather than involving a whole lobe. As the disease progresses, however, the look can tend to lobar pneumonia.
Absence of leukocytosis.
Extrapulmonary symptoms, related to the causing organism.
Moderate amount of sputum, or no sputum at all (i.e. non-productive).
Lack of alveolar exudate.
Despite general symptoms and problems with the upper respiratory tract (such as high fever, headache, a dry irritating cough followed later by a productive cough with radiographs showing consolidation), there are in general few physical signs. The patient looks better than the symptoms suggest.
Silent hypoxia may occur and not be noticed, but will be picked up by pulse oximetry.
The most common causative organisms are (often intracellular living) bacteria:
Chlamydia pneumoniae Mild form of pneumonia with relatively mild symptoms.
Chlamydia psittaci Causes psittacosis.
Coxiella burnetii Causes Q fever.
Francisella tularensis Causes tularemia.
Official source
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