Fastidious intracellular bacteria as causal agents of community-acquired pneumonia.

摘要: Intracellular bacteria are common causes of community-acquired pneumonia that grow poorly or not at all on standard culture media and do respond to beta-lactam antibiotic therapy. Apart from well-established agents such as Legionella pneumophila, Mycoplasma pneumoniae, Chlamydia psittaci Coxiella burnetii, some new emerging pathogens have recently been recognized, mainly Parachlamydia acanthamoebae Simkania negevensis, two Chlamydia-related bacteria. Most them benign self-limited infections. However, they may cause severe in cases (i.e., Legionnaires' disease) outbreaks representing a public health problem deserving prompt recognition appropriate Although extrapulmonary manifestations often present, no clinical features allow be distinguished classical bacterial Streptococcus pneumoniae. Thus, specific molecular diagnostic tools very helpful for early the offending bacteria, whereas serology only allows retrospective late diagnosis. Macrolides remain best empirical treatment intracellular respiratory pathogens, although observational studies suggest quinolones superior legionellosis.