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Intensive Care Medicine
Published in: Intensive Care Medicine 9/2016

01-09-2016 | Review

Community-acquired pneumonia related to intracellular pathogens

Authors: Catia Cillóniz, Antoni Torres, Michael Niederman, Menno van der Eerden, James Chalmers, Tobias Welte, Francesco Blasi

Published in: Intensive Care Medicine | Issue 9/2016

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Abstract

Community-acquired pneumonia (CAP) is associated with high rates of morbidity and mortality worldwide; the annual incidence of CAP among adults in Europe has ranged from 1.5 to 1.7 per 1000 population. Intracellular bacteria are common causes of CAP. However, there is considerable variation in the reported incidence between countries and change over time. The intracellular pathogens that are well established as causes of pneumonia are Legionella pneumophila, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Chlamydophila psittaci, and Coxiella burnetii. Since it is known that antibiotic treatment for severe CAP is empiric and includes coverage of typical and atypical pathogens, microbiological diagnosis bears an important relationship to prognosis of pneumonia. Factors such as adequacy of initial antibiotic or early de-escalation of therapy are important variables associated with outcomes, especially in severe cases. Intracellular pathogens sometimes appear to cause more severe disease with respiratory failure and multisystem dysfunction associated with fatal outcomes. The clinical relevance of intracellular pathogens in severe CAP has not been specifically investigated. We review the prevalence, general characteristics, and outcomes of severe CAP cases caused by intracellular pathogens.
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Metadata
Title
Community-acquired pneumonia related to intracellular pathogens
Authors
Catia Cillóniz
Antoni Torres
Michael Niederman
Menno van der Eerden
James Chalmers
Tobias Welte
Francesco Blasi
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 9/2016
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-016-4394-4

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