When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Atypical pneumonia

查看 PDF
  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源
最后审阅： 21 Nov 2025
最后更新： 10 Sep 2024

小结

定义

病史和体格检查

关键诊断因素

  • age <50 years
  • persistent cough
  • dry cough
  • long duration of symptoms
完整详情

其他诊断因素

  • recent community exposure
  • throat involvement
  • fever
  • headache
  • diarrhea
  • bullous myringitis
  • lung rales/crepitations
  • rash
完整详情

危险因素

  • close community settings
  • immunosuppression
  • cigarette smoking
  • chronic lung disease
  • travel
  • male sex
  • immunomodulating drugs
完整详情

诊断性检查

首要检查

  • 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
完整详情

需考虑的检查

  • urinary Legionella antigen
  • sputum culture
  • molecular diagnosis of Mycoplasma pneumoniae or Chlamydophila pneumoniae
  • nasopharyngeal PCR
完整详情

治疗流程

急症处理

presumed atypical bacterial pneumonia: nonpregnant adult

presumed atypical bacterial pneumonia: pregnant or child

撰稿人

作者

Lorenzo Di Francesco, MD, SFHM, FACP

Professor of Medicine

Department of Medicine

Division of General Internal Medicine

Emory University School of Medicine

GA

利益声明

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

同行评议者

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

利益声明

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

Disclosures

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

Disclosures

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.

References

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.

Key articles

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.Full text  Abstract

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.Full text  Abstract

Reference articles

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

  • Differentials

    • Coronavirus disease 2019 (COVID-19)
    • Typical bacterial pneumonia
    • Viral pneumonia
    More Differentials

  • Guidelines

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

  • Patient information

    Pneumonia

    More Patient information

  • Calculators

    Community-acquired pneumonia severity index (PSI) for adults

    CURB-65 pneumonia severity score

    More Calculators

  • Videos

    Tracheal intubation: animated demonstration

    Bag-valve-mask ventilation: animated demonstration

    More videos
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer