History and exam
Key diagnostic factors
Other diagnostic factors
Fever, if present, is usually low grade.
Headache may accompany Mycoplasma pneumoniae and Chlamydophila pneumoniae infections.
Diarrhoea may accompany Legionella infections.
Bullous myringitis is rare sign that suggests Mycoplasma pneumoniae infection.
Clinical signs of pneumonia may be mild or absent.
A mainly self-limited maculopapular or vesicular rash can accompany Mycoplasma pneumoniae pneumonia.
Many studies have shown that exposure to Mycoplasma pneumoniae and Chlamydophila pneumoniae in close community settings such as boarding schools, college dormitories, army basic training camps, or even hospitals can lead to outbreaks of infection with these pathogens. This takes place mainly by person-to-person transmission among people in close proximity to each other.
A few studies have shown that people who smoke are at greater risk for developing pneumonia due to infection with Mycoplasma pneumoniae, Legionella pneumophila, and probably Coxiella burnetii. This may be related to damage to ciliated epithelium and/or modification of the host immune response.
One prospective incidence study has shown a possible association between patients receiving tumour necrosis factor (TNF)-alpha antagonists and Legionella pneumophila pneumonia.
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