Community-Acquired Pneumonia (eBook)

Contents 6
List of contributors 8
Preface 10
Abstract 11
Introduction 11
Diagnosis and treatment of community acquired pneumonia – the German perspective 11
Definition 12
Aetiology 13
Resistances 15
Risk stratification 15
Diagnostic procedures 16
Treatment 17
References 21
Detection of respiratory bacterial pathogens 25
Abstract 25
Introduction 25
Microscopy of respiratory secretions 26
Detection of pathogens by culture 29
References 33
Viral pathogens and epidemiology, detection, therapy and resistance 36
Abstract 36
Introduction 36
Viral pathogens and epidemiology 37
Factors influencing occurrence of community-acquired pneumonia ( CAP) 37
Viruses causing CAP 38
Nonconventional respiratory viruses 50
Diagnosis of viral pulmonary infection 51
Methods for detection of viruses 52
Diagnostic comments on specific viruses 54
Summary 57
References 57
Resistance in Streptococcus pneumoniae 66
Abstract 66
INTRODUCTION 66
Genetic background 67
Spread of resistance in pneumococci – the clone concept 69
Beta-lactams 71
Macrolides 72
Tetracyclines 73
Fluoroquinolones 73
Resistance to new antibiotics 74
Clinical relevance of resistance 75
Limiting the spread of resistance – the impact of vaccines 77
References 78
Abstract 82
Introduction 82
Influenza 82
Classification and structure of influenza viruses 83
Replication cycle 84
Epidemiology 85
Pathogenesis 86
Immune response 88
Clinical manifestations 89
Laboratory diagnosis 90
Prophylaxis and therapy 90
References 91
Abstract 92
Epidemiology, diagnosis and clinical manifestation 92
Pathogenesis of Chlamydophila pneumoniae infections – epidemiology, immunity, cell biology, virulence factors 92
Innate and adaptive immunity 98
Cell biology 102
Virulence factors 104
Future research directions 108
References 109
Abstract 120
Introduction 120
Legionnaires’ disease and its agent Legionella pneumophila 120
Legionellae facultative intracellular pathogen of free-living amoebae 122
Intracellular infection of L. pneumophila 124
Immunity to intracellular L. pneumophila 134
Conclusions 136
References: 136
Abstract 148
Introduction 148
Pathogenesis of Streptococcus pneumoniae infections: adaptive immunity, innate immunity, cell biology, virulence factors 148
Nasopharyngeal colonization 149
Transition from colonization to pneumonia and invasive infections 150
Cell wall structures and virulence factors of S. pneumoniae 151
Cellular biology of pneumococcal infections 154
Pulmonary virulence determinants 160
Regulation of gene expression and virulence 161
The pneumococcus and the innate immunity of the host 162
The pneumococcus and the adaptive immunity of the host 172
Global analysis of host responses 174
Conclusion 175
References 176
Abstract 191
Pathogenesis of Mycoplasma pneumoniae infections: adaptive immunity, innate immunity, cell biology, and virulence factors 191
Cell biology of Mycoplasma pneumoniae 192
Epidemiology and transmission of infection 193
Cytadherence and other virulence factors 194
Innate immunity to M. pneumoniae disease 196
Adaptive immunity and interaction of M. pneumoniae with host immune cells 196
Clinical and laboratory aspects of M. pneumoniae infections 198
Autoimmunity and extrapulmonary manifestations 199
Pathologic aspects of lung disease due to M. pneumoniae 199
Chronic lung disease associated with M. pneumoniae infection 200
Measurement of the immune response as a means for diagnosis 202
Use of the PCR assay for detection of M. pneumoniae 203
Treatment of M. pneumoniae infections 204
Summary 204
References 205
Abstract 208
Introduction 208
Community-acquired pneumonia: paving the way towards new vaccination concepts 208
Currently available vaccines 209
New advances in vaccinology 224
Concluding remarks 237
References 238
Index 253