Medicus, Vol. 14 No. 1_ARI, 2005.
Pregledni rad
Etiological Diagnosis of Atypical Pneumonias
Oktavija Đaković Rode
Sažetak
The most common agents associated
with atypical pneumonias are Mycoplasma pneumoniae,
Chlamydophila pneumoniae and Legionella pneumophila.
Chlamydophila psittaci and Coxiella burnetii have been
rarely reported. Atypical pneumonia could be also caused
by a variety of viral agents. The clinical and radiological
features of atypical pneumonia are not specifi c, and
diagnosis depends on laboratory tests. Laboratory tests
available for specifi c diagnosis include culture, serology,
direct antigen detection and molecular methods. The
etiology of atypical pneumonia is primarily based on
serology. Defi nitive diagnosis through serologic testing
is usually retrospective. Either a high initial titer or a
fourfold or greater rise between the acute and convalescent
serum is considered diagnostic in patients with clinical
symptoms of atypical pneumonia. Serologic response can
differ, cultures are cumbersome and time-consuming, and
molecular methods are not standardized. Therefore, none
of the available diagnostic tests fulfi ls all expectations in
a diagnosis of atypical pneumonia. Only the simultaneous
combination of different methods, immediate testing of
acute and later of paired sera, antigen detection and, if
possible, cultivation of pathogens, can defi ne the etiology
of atypical pneumonia more promptly and accurately.
Communication and cooperation among clinicians and
microbiologists is essential for successful results. The key
reason to make a defi nitive etiological diagnosis of these
atypical pathogens is to approve the prescription of empiric
therapy, clarify the epidemiology of the disease, and control
disease outbreaks.
Ključne riječi
atypical pneumonia; diagnostics; serology; M. pneumoniae; C. pneumoniae; L. pneumophila; C. psittaci; C. burnetii
Hrčak ID:
18540
URI
Datum izdavanja:
26.1.2005.
Posjeta: 7.646 *