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Infantile chlamydial pneumonia—A review based on 115 cases

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Abstract

Clinical manifestations, diagnostic studies and management of chlamydial pneumonia were reviewed in 115 infants and compared to those from 21 infants with interstitial pertussoid eosinophilic pneumonia. The identity of these two forms of subacute afebrile pneumonia is suggested. Chlamydial pneumonia is natally acquired, essentially occurs during the second and third month of life, and its frequency in the United States is surprisingly high. Gradual onset of respiratory tract symptoms, lack of possible infection from symptomatic persons, afebrile course and staccato cough represent the typical anamnesis. Presence of conjunctivitis and serous otitis is common. Distinctive diagnostic studies include slight eosinophilia (lhen300 eosinophils/mm3), elevated serum immunoglobulins M and G, depressed PO2 and normal PCO2 in arterial blood under room air, and both interstitial infiltrates and hyperexpansion of nhe lungs on chest roentgenogram. Chlamydial cultures of nasopharyngeal secretions or tracheal aspirates, and determination of antichlamydial antibody titers in serum are indicated in establishing the etiology. Adequate management consists of antichlamydial chemotherapy and general supportive care, including chest physiotherapy and oxygen and parenteral fluids when needed.

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Curriculum vitae. Urs B. Schaad was born 1945 in Switzerland. He graduated 1971 from the Medical Faculty of the Bernese University and his postgraduate training included 1 year General Surgery (Lugano), 11/2 years Internal Medicine (Langenthal) and 41/2 years Pediatrics (Berne). From 1978 to 1980 he completed a Research Fellowship in Pediatric Infectious Diseases at the University of Texas at Dallas, USA (Directors of Program: Prof. George H. McCracken, Jr., and Prof. John D. Nelson). Since 1981 he is back at the Department of Pediatrics, University of Berne (Head: Prof. E. Rossi), conducting clinical, research and teaching activities in Pediatric Infectious Diseases. Main topics of research have been experimental meningitis and studies on pharmacokinetics and efficacy of different antimicrobial agents in pediatric patients. Previous reviews included recrudescence and relapse in bacterial meningitis, atypical myobacterial lymphadenitis, melioidosis, pyogenic sacroiliitis and arthritis in meningococcal disease.

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Schaad, U.B., Rossi, E. Infantile chlamydial pneumonia—A review based on 115 cases. Eur J Pediatr 138, 105–109 (1982). https://doi.org/10.1007/BF00441134

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