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Pneumonia atípica

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  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
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Última revisão: 20 Aug 2025
Última atualização: 10 Sep 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • idade <50 anos
  • tosse persistente
  • tosse seca
  • longa duração dos sintomas
Detalhes completos

Outros fatores diagnósticos

  • exposição recente na comunidade
  • comprometimento da garganta
  • febre
  • cefaleia
  • diarreia
  • miringite bolhosa
  • estertores/crepitações pulmonares
  • erupção cutânea
Detalhes completos

Fatores de risco

  • cenários comunitários de contato próximo
  • imunossupressão
  • tabagismo
  • doença pulmonar crônica
  • viagens
  • sexo masculino
  • medicamentos imunomoduladores
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • saturação de oxigênio no ar
  • contagem leucocitária
  • hemoglobina
  • Testes da função hepática
  • nível de ureia sérica
  • reação em cadeia da polimerase via transcriptase reversa (RT-PCR) em tempo real para SARS-CoV-2.
  • radiografia torácica
Detalhes completos

Investigações a serem consideradas

  • antígeno urinário de Legionella
  • cultura de escarro
  • diagnóstico molecular de Mycoplasma pneumoniae ou Chlamydophila pneumoniae
  • reação em cadeia da polimerase nasofaríngea
Detalhes completos

Algoritmo de tratamento

AGUDA

suspeita de pneumonia bacteriana atípica: adulto não gestante

suspeita de pneumonia bacteriana atípica: gestantes ou crianças

Составители

Авторы

Lorenzo Di Francesco, MD, SFHM, FACP

Professor of Medicine

Department of Medicine

Division of General Internal Medicine

Emory University School of Medicine

GA

Раскрытие информации

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

Рецензенты

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

利益声明

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.

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