Patient will present as → a 45-year-old male with a one week history of hacking non-productive cough, low grade fever, malaise and myalgias. The chest x-ray reveals bilateral interstitial infiltrates and a cold agglutinin titer that is negative. Examination reveals scattered rhonchi and rales upon auscultation of the chest.
Adults → Flu is the most common viral cause
Kids → RSV - 1st episode of wheezing
Adenovirus tends to cause symptoms fast, will present with GI symptoms and lasts about 1 week. May differentiate from bacterial mycoplasma pneumonia as mycoplasma is slow and insidious.
Chest X-ray will show bilateral interstitial infiltrates
- Rapid antigen testing for influenza
- RSV nasal swab
- cold agglutinin titer that is negative
Influenza can be treated with oseltamivir (Tamiflu)
- Zanamivir and Oseltamivir (Tamiflu) both treat influenza A and B must be given within 48 hours
- Amantadine and Rimantadine treat only influenza A
Treatment is usually symptomatic, may use beta 2 agonists, fluids, rest
While the patient's clinical symptoms of dry cough and rhonchi support this diagnosis, the chest x-ray would be normal or only show a mild increase in bronchovascular markings, not infiltrates.
While the gradual onset of symptoms suggest mycoplasma, the negative cold agglutinin titer makes this less likely.
In older children the signs and symptoms of pneumococcal pneumonia are similar to an adult and consist of an abrupt onset of cough, fever and chills. The chest x-ray would reveal a lobar consolidation, not interstitial, picture.