Overview
Why has the reported incidence of viral pneumonia been increasing?
What are the signs and symptoms of viral pneumonia?
Which physical findings are characteristic of viral pneumonia?
What are the symptoms of influenza pneumonia?
What are the symptoms of respiratory syncytial virus (RSV) pneumonia?
What are the symptoms of parainfluenza virus (PIV) pneumonia?
Which lab studies are performed in the workup of viral pneumonia?
What is the role of radiography in the diagnosis of viral pneumonia?
What is the role of lung biopsy and histologic studies in the diagnosis of viral pneumonia?
What is included in supportive care for viral pneumonia?
What are specific treatments for the various types of viral pneumonia?
How common is viral pneumonia?
Which viruses causes viral pneumonia?
What is the pathophysiology of viral pneumonia?
What is the role of influenza virus in the pathophysiology of viral pneumonia?
What is the role of adenoviruses in the pathophysiology of viral pneumonia?
Why are the elderly at increased risk for complications from viral pneumonia?
What are the ways viral pneumonia is transmitted?
What pathophysiology of pulmonary host defense against viral pneumonia?
What is the role of measles virus in the etiology of viral pneumonia?
What is the role of cytomegalovirus (CMV) in the etiology of viral pneumonia?
Which virus families cause viral pneumonia?
Which lung pathogens cause viral pneumonia?
What is the role of influenza virus in the etiology of viral pneumonia?
What is the role of respiratory syncytial virus (RSV) in the etiology of viral pneumonia?
What is the role of adenoviruses in the etiology of viral pneumonia?
What is the role of parainfluenza virus (PIV) in the etiology of viral pneumonia?
What is the role of rhinovirus in the etiology of viral pneumonia?
What is the role of human metapneumovirus (hMPV) in the etiology of viral pneumonia?
What is the role of coronavirus in the etiology of viral pneumonia?
What is the role of varicella-zoster virus (VZV) in the etiology of viral pneumonia?
What is the role of herpes simplex virus (HSV) in the etiology of viral pneumonia?
What causes zoonotic viral pneumonia?
What is the role of Hantavirus in the etiology of viral pneumonia?
What is the role of avian H5N1 influenza virus in the etiology of viral pneumonia?
What is the role of severe acute respiratory syndrome (SARS) in the etiology of viral pneumonia?
What is the role of H1N1 (swine) influenza in the etiology of viral pneumonia?
What is the role of Epstein-Barr virus (EBV) in the etiology of viral pneumonia?
What is the role of rotavirus in the etiology of viral pneumonia?
What is the prevalence of viral pneumonia?
What is the prevalence of viral pneumonia in immunocompromised hosts?
What is the prevalence of viral pneumonia in pregnancy?
How does the prevalence of viral pneumonia vary by sex?
How does the prevalence of viral pneumonia vary by age?
What is the mortality and morbidity of viral pneumonia?
What is the mortality and morbidity of influenza pneumonia?
What is the mortality and morbidity of respiratory syncytial virus (RSV) pneumonia?
What is the mortality and morbidity of adenovirus pneumonia?
What is the mortality and morbidity of parainfluenza virus (PIV) pneumonia?
What is the mortality and morbidity of human metapneumovirus (HMPV) pneumonia?
What is the mortality and morbidity of varicella-zoster virus (VZV) pneumonia?
What is the mortality and morbidity of measles virus pneumonia?
What is the mortality and morbidity of cytomegalovirus (CMV) pneumonia?
What is the mortality and morbidity of herpes simplex virus (HSV) pneumonia?
What is the mortality and morbidity of Hantavirus pulmonary syndrome (HPS)?
What is the prognosis of viral pneumonia?
Where are resources for patient education about viral pneumonia found?
Presentation
Which clinical history findings suggest viral pneumonia?
What are the clinical manifestations of human lymphotropic virus (HTLV) pneumonia?
Which physical findings are characteristic of viral pneumonia?
Which patient groups are at highest risk for Influenza pneumonia?
What are the clinical forms of influenza pneumonia?
What are the risk factors for respiratory syncytial virus (RSV) pneumonia?
Which physical findings are characteristic of RSV pneumonia?
What are the clinical manifestations of parainfluenza virus (PIV) pneumonia?
What are the clinical manifestations of human metapneumovirus (HMPV) pneumonia?
What are the clinical manifestations of coronavirus pneumonia?
What are the clinical manifestations of varicella-zoster virus (VZV) pneumonia?
Which factors increase the risk for varicella-zoster virus (VZV) pneumonia?
What are the clinical manifestations of Measles virus pneumonia?
Which factors increase the risk for Measles virus pneumonia?
Which physical findings are characteristic of specific types of measles-associated pneumonia?
What are the clinical manifestations of cytomegalovirus (CMV) pneumonia?
What are the possible outcomes and complications of cytomegalovirus (CMV) pneumonia?
What are the clinical manifestations of herpes simplex virus (HSV) pneumonia?
What are the clinical manifestations of Hantavirus pulmonary syndrome (HPS)?
What are the clinical manifestations of adenovirus pneumonia?
What are the clinical manifestations of avian influenza (A/H7N7) pneumonia?
What are the clinical manifestations of Epstein-Barr virus (EBV) pneumonia?
What are the clinical manifestations of human herpesvirus (HHV) pneumonia?
What are the clinical manifestations of HIV pneumonitis?
What are the clinical manifestations of rhinovirus pneumonia?
What are the clinical manifestations of rotavirus pneumonia?
What are the clinical manifestations of transplantation-related pneumonia?
What are the complications of viral pneumonia?
DDX
How is viral pneumonia differentiated from bacterial pneumonia?
Which etiologies of viral pneumonia are most common in the winter months?
What are common causes of viral pneumonia in children?
What are common causes of viral pneumonia in immunocompetent adults?
What are the common causes of viral pneumonia in immunocompromised hosts?
What are the differential diagnoses for Viral Pneumonia?
Workup
Which diagnostic techniques are used in the diagnosis of viral pneumonia?
Which tests are used to identify the etiology of viral pneumonia?
What is the role of cytologic evaluation in the evaluation of viral pneumonia?
What is the role of viral culture in the workup of viral pneumonia?
What is the role of Sputum Gram stains in the workup of viral pneumonia?
What is the role of blood cultures in the workup of viral pneumonia?
What is the role of rapid antigen detection in the workup of viral pneumonia?
What is the role of gene amplification in the workup of viral pneumonia?
What is the role of serologies in the workup of viral pneumonia?
What is the role of arterial blood gases in the workup of viral pneumonia?
What are virus-specific lab studies for the diagnosis of viral pneumonia?
Which virus-specific lab studies are used for the diagnosis of influenza pneumonia?
Which virus-specific lab studies are used for the diagnosis of adenoviruses pneumonia?
Which virus-specific lab studies are used for the diagnosis of parainfluenza virus (PIV) pneumonia?
Which virus-specific lab studies are used for the diagnosis of measles virus pneumonia?
Which virus-specific lab studies are used for the diagnosis of cytomegalovirus (CMV) pneumonia?
Which virus-specific lab studies are used for the diagnosis of herpes simplex virus (HSV) pneumonia?
Which virus-specific lab studies are used for the diagnosis of hantavirus-caused pneumonia?
Which findings on chest radiography are characteristic of viral pneumonia?
Which findings on chest radiography are characteristic of influenza pneumonia?
Which findings on chest radiography are characteristic of avian (H5N1) influenza pneumonia?
Which findings on chest radiography are characteristic of S-OIV pneumonia?
Which findings on chest radiography are characteristic of adenovirus pneumonia?
Which findings on chest radiography are characteristic of parainfluenza virus (PIV) pneumonia?
Which findings on chest radiography are characteristic of human metapneumovirus (hMPV) pneumonia?
Which findings on chest radiography are characteristic of coronavirus pneumonia?
Which findings on chest radiography are characteristic of varicella-zoster virus (VZV) pneumonia?
Which findings on chest radiography are characteristic of cytomegalovirus (CMV) pneumonia?
Which findings on chest radiography are characteristic of herpes simplex virus (HSV) pneumonia?
Which findings on chest radiography are characteristic of Hantavirus pulmonary syndrome (HPS)?
What are the pathognomonic findings on chest radiographs of viral pneumonia?
What is the role of lung biopsy in patients with viral pneumonia?
What is the role of bronchiolar lavage (BAL) in the workup of viral pneumonia?
Which histologic findings are characteristic of viral pneumonia?
Which histologic findings are characteristic of herpes simplex virus (HSV) pneumonias?
Which histologic findings are characteristic of Hantavirus pulmonary syndrome (HPS) and pneumonia?
Treatment
What is included in supportive care for viral pneumonia?
When is oxygen administered in the supportive care of viral pneumonia?
When is isotonic sodium chloride administered in the supportive care of viral pneumonia?
What are the options for acute management of viral pneumonia?
What is the role of antiviral therapy in the treatment of influenza pneumonia?
Which medications are used for treatment of influenza A and B pneumonia?
Which medications are used for the treatment of H1N1 influenza pneumonia?
Which medications are used for the treatment of for avian (H5N1) influenza pneumonia?
Which medications are used for the treatment of respiratory syncytial virus (RSV) pneumonia?
Which medications are used for the treatment of adenovirus pneumonia?
Which medications are used for the treatment of parainfluenza virus (PIV) pneumonia?
Which medications are used for the treatment of human metapneumovirus (HMPV) pneumonia?
Which medications are used for the treatment of coronavirus pneumonia?
What are the treatment options for varicella-zoster virus (VZV) pneumonia?
Which medications are used in the treatment of measles pneumonia?
Which medications are used for the treatment of cytomegalovirus (CMV) pneumonia?
Which medications are used for the treatment of herpes simplex virus (HSV) pneumonia?
What are the treatment options for Hantavirus pulmonary syndrome (HPS)?
How is influenza pneumonia prevented?
What are the CDC guidelines for prevention of influenza pneumonia?
How is respiratory syncytial virus (RSV) pneumonia prevented?
How is adenovirus pneumonia prevented?
How is parainfluenza virus (PIV) pneumonia prevented?
How is human metapneumovirus (HMPV) pneumonia prevented?
How is varicella-zoster virus (VZV) pneumonia prevented?
How is measles pneumonia prevented?
How is cytomegalovirus (CMV) pneumonia prevented?
How is herpes simplex virus (HSV) pneumonia prevented?
How is Hantavirus pulmonary syndrome (HPS) prevented?
How is viral pneumonia prevented in hematopoietic cell transplantation recipients?
Which medical personnel provide consultation to patients with viral pneumonia?
Medications
What are the goals of drug treatment for viral pneumonia?
Which medications in the drug class Beta-Agonists are used in the treatment of Viral Pneumonia?
Which medications in the drug class Immune Globulins are used in the treatment of Viral Pneumonia?
Which medications in the drug class Antiviral agents are used in the treatment of Viral Pneumonia?
Which medications in the drug class Vaccines are used in the treatment of Viral Pneumonia?
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Pneumonia, viral: A 52-year-old woman developed fever, cough, and dyspnea. She also developed a rash that was prominent over the face and the trunk. The chest radiograph showed interstitial infiltrates, with suggestion of a micronodular process. The Tzanck smear results from the skin vesicle suggest varicella-zoster virus.
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Pneumonia, viral: A 52-year-old woman developed fever, cough, and dyspnea. She also developed a rash that was prominent over the face and the trunk. The chest radiograph showed interstitial infiltrates, with suggestion of a micronodular process. The Tzanck smear results from the skin vesicle suggest varicella-zoster virus. She was treated with acyclovir; resolution of varicella-zoster virus infection occurred after 7 days of therapy.
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Bilateral interstitial infiltrates in a 31-year-old patient with influenza pneumonia.
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Right-middle-lobe infiltrate in a 2-month-old boy with pneumonia due to respiratory syncytial virus (RSV).
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High-power Papanicolaou (Pap) stain showing a virus on a bronchial wash. Viruses in general show "smudgy" nuclei, may or may not show nuclear or cytoplasmic inclusions, and may demonstrate other features such as multinucleation or margination of chromatin to the periphery of the cell nucleus. Certain features are more indicative of one virus over another. This is an example of herpes virus (cells infected are located in the center right).
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High-power Papanicolaou (Pap) stain of cytomegalovirus (center). This cell has a very large, dark intranuclear inclusion.
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High-power hematoxin-and-eosin stain of giant cell pneumonia following measles. A multinucleated cell (center) contains eosinophilic intranuclear inclusions.
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High-power hematoxin-and-eosin stain of numerous cells infected with the cytomegalovirus (large cells with enlarged nuclei containing dark-purple intranuclear inclusions surrounded by a clear halo).
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High-power hematoxin-and-eosin stained herpes simplexvirus, characterized by "smudgy" degenerating nuclei. Some cells are multinucleated with margination of the chromatin to the periphery of the nuclei and molding of the nuclei to each other.
Tables
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- Overview
- Presentation
- DDx
- Workup
- Treatment
- Approach Considerations
- Supportive Care
- Influenza Pneumonia
- Respiratory Syncytial Virus Pneumonia
- Adenovirus Pneumonia
- Parainfluenza Virus Pneumonia
- Human Metapneumovirus Pneumonia
- Coronavirus Pneumonia
- Varicella-Zoster Virus Pneumonia
- Measles Pneumonia
- Cytomegalovirus Pneumonia
- Herpes Simplex Virus Pneumonia
- Hantavirus Pneumonia
- Prevention
- Consultations
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- Medication
- Questions & Answers
- Media Gallery
- Tables
- References