From the Guidelines
Multifocal pneumonia is most commonly caused by Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, Chlamydophila pneumoniae, and respiratory viruses, as these pathogens are frequently identified in patients with community-acquired pneumonia 1.
Causes of Multifocal Pneumonia
The causes of multifocal pneumonia can be diverse, including:
- Bacterial pathogens such as Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae
- Atypical organisms like Mycoplasma pneumoniae, Legionella pneumophila, and Chlamydia pneumoniae
- Viral infections, including influenza, respiratory syncytial virus (RSV), and adenovirus
- Aspiration of gastric contents, particularly in patients with impaired consciousness or swallowing difficulties ### Risk Factors Risk factors that increase susceptibility to multifocal pneumonia include:
- Compromised immune systems (from HIV/AIDS, chemotherapy, or immunosuppressive medications)
- Advanced age
- Chronic lung diseases
- Smoking
- Alcoholism
- Recent hospitalization ### Pathogenesis The multifocal pattern develops when infectious agents spread through the airways to different lung segments or through the bloodstream to multiple lung regions simultaneously, creating the characteristic pattern of scattered infiltrates visible on chest imaging 2.
Diagnosis and Treatment
Diagnosis of multifocal pneumonia involves a combination of clinical evaluation, laboratory tests, and imaging studies, including chest radiography and computed tomography (CT) scans 1. Treatment typically involves antimicrobial therapy, with the choice of antibiotics depending on the suspected or confirmed causative pathogen and its antibiotic susceptibility 1.
From the Research
Causes of Multifocal Pneumonia
- Multifocal pneumonia can be caused by a variety of microorganisms, including bacteria, respiratory viruses, and fungi 3.
- The development of the disease largely depends on the host immune response, with pathogen characteristics having a less prominent role 3.
- Individuals with pneumonia often present with respiratory and systemic symptoms, and diagnosis is based on both clinical presentation and radiological findings 3.
Common Pathogens
- Streptococcus pneumoniae and Haemophilus influenzae are common pathogens in community-acquired pneumonia and hospitalized patients with pneumonia 4.
- Respiratory syncytial virus (RSV) and Streptococcus pneumoniae are the most frequent pathogens associated with severe community-acquired pneumonia (SCAP) among children 5.
- Influenza virus and Pseudomonas aeruginosa are the most frequent pathogens associated with SCAP among older adults 5.
Infection and Co-infection Patterns
- Infection or co-infection patterns, along with their age dependence and clinical effects, are poorly understood 5.
- The prevalence and infection pattern of respiratory pathogens differ between patients with SCAP and patients with non-SCAP in an age-dependent manner 5.
- Asymptomatic pneumococcal carriage may also affect subsequent influenza virus infection and the clinical outcome 6.
Impact of COVID-19 Pandemic
- The introduction of COVID-19 containment policies and public information campaigns likely reduced transmission of Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis, leading to a significant reduction in life-threatening invasive diseases in many countries worldwide 7.
- The incidence of reported Streptococcus pneumoniae infections decreased by 68% at 4 weeks and 82% at 8 weeks following the week in which significant changes in population movements were recorded 7.