Gordon R C
Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Kalamazoo Center for Medical Studies, Kalamazoo, MI 49008, USA.
Adolesc Med. 2000 Oct;11(3):681-95.
Community acquired pneumonia (CAP) is defined as pneumonia acquired outside of the hospital setting. Extensive studies of CAP in adolescents that characterize the true incidence of various etiologic pathogens are not available. However, Streptococcus pneumoniae, Mycoplasma pneumoniae, and Chlamydia pneumoniae appear to be the most frequently encountered pathogens. These organisms often cause CAP in adults as well; other infections are noted as well, including Legionella. "Atypical pneumonia" refers to pneumonia not presenting with the usual clinical picture of pneumococcal infection (which includes high fever, productive cough, chills, and other "classic" features). The term is frequently used in adolescents with CAP. However, this classification may not help in individual patients, who often show a high degree of variability in the clinical presentation of pneumonia; also it does not always predict microbial cause. There is currently a trend away from the concept of atypical pneumonia syndrome and more discussion of atypical pathogens as commonly causes of CAP. This article reviews recent literature on CAP with special emphasis on its diagnosis and management in adolescent patients.
社区获得性肺炎（CAP）被定义为在医院环境之外获得的肺炎。目前尚无关于青少年CAP的广泛研究来确定各种病原体的真实发病率。然而，肺炎链球菌、肺炎支原体和肺炎衣原体似乎是最常见的病原体。这些病原体在成人中也常引起CAP；也有其他感染被提及，包括军团菌。“非典型肺炎”是指不表现出肺炎球菌感染常见临床表现（包括高热、咳痰、寒战及其他“典型”特征）的肺炎。该术语常用于患有CAP的青少年。然而，这种分类对个体患者可能并无帮助，因为肺炎的临床表现往往具有高度变异性；而且它也不能总是预测微生物病因。目前有一种趋势，即不再使用非典型肺炎综合征这一概念，而是更多地讨论非典型病原体作为CAP常见病因的情况。本文回顾了关于CAP的近期文献，特别强调了其在青少年患者中的诊断和管理。
