Atypical pneumonia

Question 1

Symptoms of atypical pneumonia

Answer 1

Non-productive cough, fever, maculopapular rash, bilateral crackles

Question 2

Chest Xray result for atypical pneumonia

Answer 2

Bilateral fluffy infiltrates. Less “solid” and distinct. More in bronchi and bronchioles

Question 3

Result of sputum for atypical pneumonia

Answer 3

Neutrophils but no organisms

Question 4

Most likely causes of atypical pneumonia?

Answer 4

Mycoplasma pneumonia (Xray looks worse than patient)

Question 5

Mycoplasma pneumoniae description

Answer 5

Small, no cell wall (no gram stain!), Virulence factors: has sterols like human cells (evades), P1 (binds epithelial cells), H2O2.

Question 6

Mycoplasma pneumoniae pathogenesis

Answer 6

From droplets. Actually line up on bronchi and bronchioles, but not alveoli. H2O2 damages cilia and they die and slough off. Some ABs cross react and cause hemolysis or RBC agglutination at cold Temp

Question 7

Extra-pulmonary symptoms of M pneumoniae

Answer 7

Rash, Cardiac abnormalities, Aseptic meningitis or encephalitis, Polyarthralgias

Question 8

How to confirm Mycoplasm?

Answer 8

Hard, takes time. PCR, culture, or serology - usually a few weeks. Acid fast stain? No, only for TB

Question 9

What other bacteria can cause atypical pneumonia?

Answer 9

Chlamydia sp (also don’t show up well on gram stain) and Legionella