Pitfalls in the Diagnosis of Atypical Pneumonia

Abstract

We have had the impression that primary atypical pneumonia has been considered a disease easy to diagnose and simple to handle. This has been due, at least in part, to the very low mortality and the lack of effective specific therapy. It is hoped that this will serve to emphasize the following points: 1. Frequently it is very difficult, if not impossible, to differentiate primary atypical pneumonia from pneumococcic pneumonia. This should be done, if possible, in order that specific therapy be administered if indicated and withheld if not indicated. 2. Primary atypical pneumonia might often simulate pulmonary tuberculosis in its various manifestations and on rare occasion might be confused with pulmonary tumor. 3. It might well be impossible to differentiate primary atypical pneumonia from bronchiectasis during the acute stage. In a case of suspected bronchiectasis following primary atypical pneumonia, it is well to allow a period of observation and repeat the bronchogram before deciding upon surgical treatment of the bronchiectasis. The importance of differentiating primary atypical pneumonia from this and the conditions mentioned above is self-evident.