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.

Neumonía atípica

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 13 Apr 2025
Last updated: 10 Sep 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
  • edad <50 años
  • tos persistente
  • tos seca
  • duración prolongada de síntomas
Full details

Other diagnostic factors

  • exposición reciente en la comunidad
  • afectación de la garganta
  • fiebre
  • cefalea
  • diarrea
  • miringitis ampollar
  • estertores/crepitaciones pulmonares
  • erupción
Full details

Risk factors

  • entornos comunitarios cerrados
  • inmunosupresión
  • tabaquismo
  • enfermedad pulmonar crónica
  • viajes
  • sexo masculino
  • fármacos inmunomoduladores
Full details

Diagnostic tests

1st tests to order

  • saturación de oxígeno en aire
  • recuento de leucocitos
  • hemoglobina
  • Pruebas de función hepática (PFH)
  • nivel de urea sérica
  • reacción en cadena de la polimerasa de transcripción inversa en tiempo real (RT-PCR) para SARS-CoV-2
  • radiografía de tórax
Full details

Tests to consider

  • antígeno de Legionella en orina
  • cultivo de esputo
  • diagnóstico molecular de Mycoplasma pneumoniae o de Chlamydophila pneumoniae
  • PCR nasofaríngea
Full details

Treatment algorithm

ACUTE

neumonía presuntamente causada por bacterias atípicas: adulto (sin embarazo)

neumonía presuntamente causada por bacterias atípicas: mujer embarazada o niño

Contributors

Authors

Lorenzo Di Francesco, MD, SFHM, FACP
Lorenzo Di Francesco

Professor of Medicine

Department of Medicine

Division of General Internal Medicine

Emory University School of Medicine

GA

Disclosures

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

Peer reviewers

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

Disclosures

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).

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

    • Enfermedad de coronavirus 2019 (COVID-19)
    • Neumonía bacteriana típica
    • Neumonía viral
    More Differentials

  • Guidelines

    • Pneumonia in adults: diagnosis and management
    • Pneumonia in adults: diagnosis and management
    More Guidelines

  • Patient information

    Pneumonia

    More Patient information

  • Calculators

    Índice de la gravedad de la neumonía adquirida en la comunidad (PSI) para adultos

    Índice de gravedad de la neumonía CURB-65

    More Calculators

  • Videos

    Demostración animada de la intubación traqueal

    Demostración animada de la ventilación bolsa-válvula-máscara

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

Use of this content is subject to our disclaimer