From the Guidelines
Extrapulmonary manifestations of atypical pneumonia can include a wide range of symptoms such as headache, fatigue, low-grade fever, myalgias, and arthralgias, as well as gastrointestinal, neurological, dermatological, cardiac, hematologic, and renal complications. These manifestations can result from direct invasion of the pathogen, immune-mediated responses, or production of autoantibodies 1. Some of the specific extrapulmonary manifestations include:
- Gastrointestinal symptoms like nausea, vomiting, diarrhea, and abdominal pain, particularly with Mycoplasma pneumoniae infections
- Neurological complications such as encephalitis, meningitis, Guillain-Barré syndrome, and transverse myelitis
- Dermatological manifestations like erythema multiforme, Stevens-Johnson syndrome, and maculopapular rashes
- Cardiac involvement presenting as myocarditis, pericarditis, or arrhythmias
- Hematologic abnormalities like hemolytic anemia and thrombocytopenia, especially with Mycoplasma infections
- Renal complications such as glomerulonephritis
- Otitis media and bullous myringitis, sometimes seen with Mycoplasma infections It's essential to consider these extrapulmonary manifestations when diagnosing and managing atypical pneumonia, as they can help distinguish it from typical bacterial pneumonia 1. In clinical practice, it's crucial to be aware of these potential complications to provide appropriate care and prevent long-term sequelae. The presence of these systemic symptoms often helps distinguish atypical pneumonia from typical bacterial pneumonia, which tends to present more acutely with high fever, productive cough, and localized respiratory symptoms.
From the Research
Extrapulmonary Manifestations of Atypical Pneumonia
The extrapulmonary manifestations of atypical pneumonia can vary depending on the causative pathogen. Some common extrapulmonary manifestations include:
- Central nervous system symptoms, such as confusion, headache, and seizures 2
- Gastrointestinal symptoms, such as diarrhea, nausea, and vomiting 2
- Cardiac symptoms, such as myocarditis and pericarditis 3
- Skin and mucous membrane symptoms, such as rash and oral ulcers 3
- Ear pain and nonproductive cough 2
- High fevers and relative bradycardia 2
- Hypophosphatemia and elevated serum transaminases 2
Specific Pathogens and Their Extrapulmonary Manifestations
Different pathogens can cause different extrapulmonary manifestations, including:
- Mycoplasma pneumoniae: can cause ear pain, nonproductive cough, and central nervous system symptoms 2, 3
- Chlamydia pneumoniae: can cause hoarseness and fever, with respiratory tract symptoms appearing later 2
- Legionella species: can cause high fevers, central nervous system symptoms, and gastrointestinal symptoms 2
Importance of Early Diagnosis and Treatment
Delayed administration of appropriate antibiotics can contribute to the development of extrapulmonary manifestations 4. Early diagnosis and treatment are crucial to prevent complications and improve outcomes. Imaging plays an important role in the diagnosis and management of atypical pneumonia, as it can suggest the possibility of an atypical infection 5.