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For further information, see CMDT Part 35-38: Infections Caused by Chlamydiae

KEY FEATURES

  • Chlamydia pneumoniae causes pneumonia and bronchitis

  • C pneumoniae causes up to 20% (depending on the study) of community-acquired pneumonias

  • C pneumoniae is second only to mycoplasma as an agent of atypical pneumonia

CLINICAL FINDINGS

  • The clinical presentation is that of an atypical pneumonia, with fever and nonproductive cough

DIAGNOSIS

  • Nucleic acid amplification tests

  • Two FDA-approved commercial assays are available

TREATMENT

  • Strains of C pneumoniae are resistant to sulfonamides

  • When a diagnosis of C pneumoniae is confirmed, azithromycin (500 mg orally on day 1 and 250 mg daily for 4 more days) is the recommended treatment

  • Doxycycline (100 mg orally or intravenously two times daily) or levofloxacin (750 mg orally or intravenously once daily), each given for approximately 7–10 days, are also expected to be effective

  • It is unclear if empiric coverage for atypical pathogens in hospitalized patients with community-acquired pneumonia provides a survival benefit or improves clinical outcome

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