Intensive Care Medicine (ICM) Practice Exam

Which of the following causative agents is considered an atypical pneumonia?

1. Haemophilus influenza

2. Legionella pneumophila

3. Moraxella catarrhalis

4. Streptococcus pneumonia

The correct answer is: Legionella pneumophila

Legionella pneumophila is considered an atypical causative agent of pneumonia due to its unique characteristics and the clinical presentation it elicits. Atypical pneumonia is typically associated with a more gradual onset of symptoms, which can include fever, malaise, dry cough, and extrapulmonary symptoms such as gastrointestinal disturbances and neurologic signs. Legionella pneumophila is particularly notable for its association with outbreaks linked to water sources such as air conditioning systems and complex plumbing systems, which differentiates it from more common pathogens. Additionally, it often requires specialized testing for diagnosis, such as urine antigen testing or culture on selective media, which further classifies it outside the typical pneumonia agents that are more likely to be detected using standard procedures for commonly identified bacteria. In contrast, the other listed organisms—Haemophilus influenza, Moraxella catarrhalis, and Streptococcus pneumonia—are generally associated with typical pneumonia, which tends to have a more rapid onset and is commonly seen in otherwise healthy individuals. These organisms can readily be identified with standard microbiological methods, which is not the case with atypical pathogens like Legionella pneumophila.