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Chlamydia pneumoniaeAka: TWAR

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  1. See Also
    1. Bacterial Pneumonia
  2. Epidemiology
    1. Highest Incidence among elderly
      1. Nursing home epidemics have recently been identified
      2. Reference
        1. Troy (1997) JAMA 277:1214
    2. Also common in young adults
    3. Causes 6-10% of community acquired Pneumonia
    4. Higher risk with comrobid illness
  3. Symptoms
    1. Atypical Pneumonia presentation
      1. Similar to Mycoplasma pneumoniae
    2. Cough (88%): Minimally productive if at all
    3. Fever (80%)
    4. Shortness of Breath (73%)
    5. Chills (73%)
    6. Nausea (73%
    7. Headache (56%)
    8. Myalgia (50%)
    9. Chest Pain (46%)
    10. Rhinitis (46%)
    11. Diarrhea (42%)
    12. Sore Throat (42%)
    13. Hoarseness (36%)
  4. Labs
    1. Chlamydia Serologies
    2. Complete Blood Count
      1. Mild Leukocytosis
  5. Radiology: Chest XRay
    1. Localized segmental infiltrate
  6. Management: Antibiotic for 10 to 14 days
    1. Primary
      1. Doxycycline
    2. Alternative antibiotics
      1. Erythromycin, Azithromycin or Clarithromycin
      2. Fluoroquinolone
  7. Prognosis
    1. Mortality may approach 9% in edlerly with comorbidity
  8. References
    1. Gilbert (2001) Sanford Antimicrobial, p. 28
    2. File (1998) Infect Dis Clin North Am 12(3):569
    3. File (1999) Clin Infect Dis 29:426
    4. Grayston (1992) Annu Rev Med 43:317
    5. Kuo (1995) Clin Microbiol Rev 8(4):451
    6. Plouffe (2000) Clin Infect Dis 31:S35
    7. Tan (1999) Can Respir J 6:15A

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