Afebrile Pneumonia Syndrome Differential Diagnoses

  • Author: Robert W Tolan Jr, MD; Chief Editor: Michael R Bye, MD   more...
 
Updated: Mar 29, 2011
 
 

Diagnostic Considerations

Some organisms acquired perinatally may not cause illness until later in infancy, including Chlamydophila pneumoniae,Ureaplasma urealyticum,Mycoplasma hominis, cytomegalovirus, and Pneumocystis jiroveci. Infants infected with these organisms present between age 4-11 weeks with an afebrile pneumonia characterized by a staccato cough, tachypnea, and, occasionally, hypoxia.

Infants with bacterial pneumonia often are febrile, but those with viral pneumonia or pneumonia caused by atypical organisms may have a low-grade fever or may be afebrile. The child's caretakers may complain that the child is wheezing or has noisy breathing.

Differentials

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; Sanofi Pasteur Honoraria Speaking and teaching; Baxter Healthcare Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching

Coauthor(s)

Judith R Grisi, PA-C  Physician Assistant, Monmouth Ocean Pulmonary Medicine, CentraState Medical Center

Disclosure: Nothing to disclose.

Specialty Editor Board

Susanna A McColley, MD  Associate Professor, Department of Pediatrics, Northwestern University, The Feinberg School of Medicine; Director of Cystic Fibrosis Center, Head, Division of Pulmonary Medicine, Children's Memorial Medical Center of Chicago

Susanna A McColley, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Sleep Disorders Association, and American Thoracic Society

Disclosure: Genentech Honoraria Speaking and teaching; Genentech Honoraria Consulting; Boston Scientific Consulting fee Consulting; Gilead Honoraria Speaking and teaching; Caremark Consulting fee Consulting; Vertex Pharmaceuticals Honoraria Speaking and teaching

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Pharmacy Editor, eMedicine

Disclosure: Nothing to disclose.

Heidi Connolly, MD  Associate Professor of Pediatrics and Psychiatry, University of Rochester; Director, Pediatric Sleep Medicine Services, Strong Sleep Disorders Center

Heidi Connolly, MD is a member of the following medical societies: American Academy of Pediatrics, American Thoracic Society, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Chief Editor

Michael R Bye, MD  Professor of Clinical Pediatrics, Division of Pulmonary Medicine, Columbia University College of Physicians and Surgeons; Attending Physician, Pediatric Pulmonary Medicine, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Medical Center

Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

References

  1. Brewster DR, De Silva LM, Henry RL. Chlamydia trachomatis and respiratory disease in infants. Med J Aust. Oct 3 1981;2(7):328-30. [Medline].

  2. Wolf DG, Greenberg D, Shemer-Avni Y, Givon-Lavi N, Bar-Ziv J, Dagan R. Association of human metapneumovirus with radiologically diagnosed community-acquired alveolar pneumonia in young children. J Pediatr. Jan 2010;156(1):115-20. [Medline].

  3. Brasfield DM, Stagno S, Whitley RJ, et al. Infant pneumonitis associated with cytomegalovirus, Chlamydia, Pneumocystis, and Ureaplasma: follow-up. Pediatrics. Jan 1987;79(1):76-83. [Medline].

  4. Fasoli L, Paldanius M, Don M, et al. Simkania negevensis in community-acquired pneumonia in Italian children. Scand J Infect Dis. 2008;40(3):269-72. [Medline].

  5. Chen CJ, Wu KG, Tang RB, Yuan HC, Soong WJ, Hwang BT. Characteristics of Chlamydia trachomatis infection in hospitalized infants with lower respiratory tract infection. J Microbiol Immunol Infect. Jun 2007;40(3):255-9. [Medline].

  6. Beem MO, Saxon E, Tipple MA. Treatment of chlamydial pneumonia of infancy. Pediatrics. Feb 1979;63(2):198-203. [Medline].

  7. Radkowski MA, Kranzler JK, Beem MO, et al. Chlamydia pneumonia in infants: radiography in 125 cases. AJR Am J Roentgenol. Oct 1981;137(4):703-6. [Medline].

  8. Geis T, Schilling S, Segerer H. [A Young Infant with Afebrile Pneumonia Caused by Chlamydia Trachomatis]. Klin Padiatr. Aug 3 2006;[Medline].

  9. Abzug MJ, Beam AC, Gyorkos EA, Levin MJ. Viral pneumonia in the first month of life. Pediatr Infect Dis J. Dec 1990;9(12):881-5. [Medline].

  10. FDA Approves Roche (RHHBY)'s Valcyte(R) to Prevent Cytomegalovirus Disease in Pediatric Patients Who Receive Heart or Kidney Transplants. Available at http://www.biospace.com/news_story.aspx?NewsEntityId=154407. Accessed November 12, 2010.

 
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