Cunha B A, Ortega A M
Infectious Disease Division, Winthrop-University Hospital, Mineola, New York, USA.
Postgrad Med. 1996 Jan;99(1):123-8, 131-2.
In atypical pneumonia, causative organisms are difficult to isolate, so careful clinical assessment is essential in arriving at a working diagnosis. Definitive diagnosis through serologic testing is usually retrospective. Either a high initial titer or a fourfold or greater rise between the acute and convalescent titer is considered diagnostic in a patient with compatible illness. Legionella and mycoplasma organisms may be cultured from respiratory secretions if plated on appropriate culture media. Using a syndromic approach, physicians can almost always differentiate typical from atypical community-acquired pneumonia and narrow diagnostic possibilities among the atypical pathogens, making possible institution of early, possibly lifesaving, empirical therapy.
在非典型肺炎中，致病微生物难以分离，因此仔细的临床评估对于做出初步诊断至关重要。通过血清学检测进行的确诊通常是回顾性的。对于患有相应疾病的患者，如果急性期滴度高或急性期与恢复期滴度之间有四倍或更高的升高，则可视为诊断依据。如果接种在合适的培养基上，军团菌和支原体可从呼吸道分泌物中培养出来。采用综合征方法，医生几乎总能区分典型与非典型社区获得性肺炎，并缩小非典型病原体的诊断可能性，从而有可能尽早开始可能挽救生命的经验性治疗。
