Bacteria

Chlamydia Pneumonia

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Chlamydia Pneumonia, Chlamydophila pneumoniae, Chlamydia pneumoniae, TWAR

  • See Also
  1. Atypical Pneumonia
  2. Bacterial Pneumonia
  3. Neonatal Chlamydia Pneumonia
  4. Chlamydiaceae
  • Epidemiology
  1. Highest Incidence among elderly
    1. Nursing Home epidemics have recently been identified
    2. Reference
      1. Troy (1997) JAMA 277:1214-8 [PubMed]
  2. Also common in young adults
  3. Causes 6-10% of Community Acquired Pneumonia
  4. Higher risk with comrobid illness
  • Pathophysiology
  1. Organism
    1. Chlamydophila pneumoniae (Chlamydia pneumoniae, TWAR)
    2. TWAR is an acronym for "Taiwan and Acute Respiratory"
  2. Contrast with Neonatal Chlamydia Pneumonia
    1. Caused by the STI Chlamydia Trachomatis via vertical transmission in newborns
  • Findings
  • Presentations
  1. Atypical Pneumonia (primary association and the one described on this page)
    1. Similar to Mycoplasma pneumoniae
  2. Other presentations
    1. Pharyngitis
    2. Tracheitis
    3. Acute Sinusitis
    4. Otitis Media
    5. Acute Bronchitis
    6. Bronchiolitis
  • Findings
  • Symptoms and Signs
  1. Cough (88%): Minimally productive if at all
  2. Fever (80%)
  3. Shortness of Breath (73%)
  4. Chills (73%)
  5. Nausea (73%
  6. Headache (56%)
  7. Myalgia (50%)
  8. Chest Pain (46%)
  9. Rhinitis (46%)
  10. Diarrhea (42%)
  11. Sore Throat (42%)
  12. Hoarseness (36%)
  • Labs
  1. Chlamydia Serologies
  2. Complete Blood Count
    1. Mild Leukocytosis
  • Imaging
  1. Chest XRay
    1. Localized segmental infiltrate in Atypical Pneumonia
  1. Primary
    1. Doxycycline 100 mg orally or IV for 14 days OR
    2. Azithromycin 500 mg orally on day 1, then 250 mg orally daily on Days 2 to 5
  2. Alternative Antibiotics
    1. Levofloxacin 750 mg orally or IV for 5 to 7 days
    2. Erythromycin or Clarithromycin
    3. Fluoroquinolone
  • Prognosis
  1. Mortality may approach 9% in edlerly with comorbidity
  • References
  1. Gilbert (2001) Sanford Antimicrobial, p. 28
  2. File (1998) Infect Dis Clin North Am 12(3):569-92 [PubMed]
  3. File (1999) Clin Infect Dis 29:426-8 [PubMed]
  4. Grayston (1992) Annu Rev Med 43:317-23 [PubMed]
  5. Kuo (1995) Clin Microbiol Rev 8(4):451-61 [PubMed]
  6. Plouffe (2000) Clin Infect Dis 31:S35-9 [PubMed]
  7. Tan (1999) Can Respir J 6:15A-9A [PubMed]
  8. Choroszy-Król (2014) Adv Clin Exp Med 23(1):123-6 +PMID: 24596014 [PubMed]