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In the
past, all pneumonias were labeled atypical if a bacterial pathogen could not be identified with Gram staining
and if the pneumonia did not respond to antibiotics.
Pneumonia etiology studies that incorporate viral studies show that respiratory syncytial virus is the
leading viral cause, being identified in 1540% of pneumonia or bronchiolitis cases admitted to hospital in
children in developing countries, followed by influenza A and B, parainfluenza, human metapneumovirus
and adenovirus.38,61,62 (http://www.who.int/bulletin/volumes/86/5/07-048769/en/)
Epidemiology
Various studies have reported differing frequencies of the other viruses causing community-acquired
pneumonias, with RSV ranging from 1-4%, adenovirus 1-4%, PIV 2-3 %, hMPV 0-4%, and coronavirus 1-14%
of pathogen-diagnosed pneumonia cases
T]he most common CT finding in hospitalized patients with MERS-CoV infection is that of bilateral
predominantly subpleural and basilar airspace, with more extensive ground-glass opacities than
consolidation," the authors conclude. "The predilection of the abnormalities to the subpleural and
peribronchovascular regions is suggestive of an organizing pneumonia pattern. Recognizing this pattern
in acutely ill patients living in or traveling from endemic areas may help in the early diagnosis of MERSCoV infection(American Journal of Roentgenology. 2014;203: 782-787)
http://america.aljazeera.com/articles/2014/5/27/mers-spreads-iran.html
Live-attenuated influenza vaccine should not be administered until 48 hours after cessation
of influenza antiviral therapy.
If influenza antiviral medications are administered within 2 weeks after receipt of liveattenuated influenza vaccine, the vaccine dose should be repeated 48 or more hours after the
last dose of antiviral medication.
. For example people younger than 65 years of age should not get the high-dose flu shot and
people who are younger than 18 years old or older than 64 years old should not get the
intradermal flu shot.