Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1998 Apr;53(4):302–307. doi: 10.1136/thx.53.4.302

Pathogenesis of lower respiratory tract infections due to Chlamydia, Mycoplasma, Legionella and viruses

P Andersen 1
PMCID: PMC1745181  PMID: 9741376

Full Text

The Full Text of this article is available as a PDF (106.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aherne W., Bird T., Court S. D., Gardner P. S., McQuillin J. Pathological changes in virus infections of the lower respiratory tract in children. J Clin Pathol. 1970 Feb;23(1):7–18. doi: 10.1136/jcp.23.1.7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Allegra L., Blasi F., Centanni S., Cosentini R., Denti F., Raccanelli R., Tarsia P., Valenti V. Acute exacerbations of asthma in adults: role of Chlamydia pneumoniae infection. Eur Respir J. 1994 Dec;7(12):2165–2168. doi: 10.1183/09031936.94.07122165. [DOI] [PubMed] [Google Scholar]
  3. Alwan W. H., Kozlowska W. J., Openshaw P. J. Distinct types of lung disease caused by functional subsets of antiviral T cells. J Exp Med. 1994 Jan 1;179(1):81–89. doi: 10.1084/jem.179.1.81. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Barker D. J., Osmond C. Childhood respiratory infection and adult chronic bronchitis in England and Wales. Br Med J (Clin Res Ed) 1986 Nov 15;293(6557):1271–1275. doi: 10.1136/bmj.293.6557.1271. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Baskerville A., Fitzgeorge R. B., Broster M., Hambleton P. Histopathology of experimental Legionnaires' disease in guinea pigs, rhesus monkeys and marmosets. J Pathol. 1983 Mar;139(3):349–362. doi: 10.1002/path.1711390310. [DOI] [PubMed] [Google Scholar]
  6. Bavastrelli M., Midulla M., Rossi D., Salzano M. Chlamydia trachomatis infection in children with wheezing simulating asthma. Lancet. 1992 May 9;339(8802):1174–1174. doi: 10.1016/0140-6736(92)90776-y. [DOI] [PubMed] [Google Scholar]
  7. Beatty W. L., Morrison R. P., Byrne G. I. Persistent chlamydiae: from cell culture to a paradigm for chlamydial pathogenesis. Microbiol Rev. 1994 Dec;58(4):686–699. doi: 10.1128/mr.58.4.686-699.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Becroft D. M. Bronchiolitis obliterans, bronchiectasis, and other sequelae of adenovirus type 21 infection in young children. J Clin Pathol. 1971 Feb;24(1):72–82. doi: 10.1136/jcp.24.1.72. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Berntsson E., Lagergård T., Strannegård O., Trollfors B. Etiology of community-acquired pneumonia in out-patients. Eur J Clin Microbiol. 1986 Aug;5(4):446–447. doi: 10.1007/BF02075702. [DOI] [PubMed] [Google Scholar]
  10. Biberfeld G., Norberg R. Circulating immune complexes in Mycoplasma pneumoniae infection. J Immunol. 1974 Jan;112(1):413–415. [PubMed] [Google Scholar]
  11. Boldy D. A., Skidmore S. J., Ayres J. G. Acute bronchitis in the community: clinical features, infective factors, changes in pulmonary function and bronchial reactivity to histamine. Respir Med. 1990 Sep;84(5):377–385. doi: 10.1016/S0954-6111(08)80072-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Bowman P., Wilt J. C., Sayed H. Chronicity and recurrence of psittacosis. Can J Public Health. 1973 Mar;64(2):167–173. [PubMed] [Google Scholar]
  13. Breiman R. F., Fields B. S., Sanden G. N., Volmer L., Meier A., Spika J. S. Association of shower use with Legionnaires' disease. Possible role of amoebae. JAMA. 1990 Jun 6;263(21):2924–2926. [PubMed] [Google Scholar]
  14. Bridge J. A., Edelstein P. H. Oropharyngeal colonization with Legionella pneumophila. J Clin Microbiol. 1983 Nov;18(5):1108–1112. doi: 10.1128/jcm.18.5.1108-1112.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Busse W. W. The relationship between viral infections and onset of allergic diseases and asthma. Clin Exp Allergy. 1989 Jan;19(1):1–9. doi: 10.1111/j.1365-2222.1989.tb02336.x. [DOI] [PubMed] [Google Scholar]
  16. Campbell L. A., Kuo C. C., Wang S. P., Grayston J. T. Serological response to Chlamydia pneumoniae infection. J Clin Microbiol. 1990 Jun;28(6):1261–1264. doi: 10.1128/jcm.28.6.1261-1264.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Carballal G., Mahony J. B., Videla C., Cerqueiro C., Chernesky M. Chlamydial antibodies in children with lower respiratory disease. Pediatr Infect Dis J. 1992 Feb;11(2):68–71. doi: 10.1097/00006454-199202000-00002. [DOI] [PubMed] [Google Scholar]
  18. Cassell G. H., Cole B. C. Mycoplasmas as agents of human disease. N Engl J Med. 1981 Jan 8;304(2):80–89. doi: 10.1056/NEJM198101083040204. [DOI] [PubMed] [Google Scholar]
  19. Chastre J., Raghu G., Soler P., Brun P., Basset F., Gibert C. Pulmonary fibrosis following pneumonia due to acute Legionnaires' disease. Clinical, ultrastructural, and immunofluorescent study. Chest. 1987 Jan;91(1):57–62. doi: 10.1378/chest.91.1.57. [DOI] [PubMed] [Google Scholar]
  20. Cianciotto N. P., Eisenstein B. I., Mody C. H., Engleberg N. C. A mutation in the mip gene results in an attenuation of Legionella pneumophila virulence. J Infect Dis. 1990 Jul;162(1):121–126. doi: 10.1093/infdis/162.1.121. [DOI] [PubMed] [Google Scholar]
  21. Cimolai N., Wensley D., Seear M., Thomas E. T. Mycoplasma pneumoniae as a cofactor in severe respiratory infections. Clin Infect Dis. 1995 Nov;21(5):1182–1185. doi: 10.1093/clinids/21.5.1182. [DOI] [PubMed] [Google Scholar]
  22. Davis G. S., Winn W. C., Jr, Gump D. W., Craighead J. E., Beaty H. N. Legionnaires' pneumonia after aerosol exposure in guinea pigs and rats. Am Rev Respir Dis. 1982 Dec;126(6):1050–1057. doi: 10.1164/arrd.1982.126.6.1050. [DOI] [PubMed] [Google Scholar]
  23. Denny F. W., Clyde W. A., Jr, Glezen W. P. Mycoplasma pneumoniae disease: clinical spectrum, pathophysiology, epidemiology, and control. J Infect Dis. 1971 Jan;123(1):74–92. doi: 10.1093/infdis/123.1.74. [DOI] [PubMed] [Google Scholar]
  24. Denny F. W., Jr The clinical impact of human respiratory virus infections. Am J Respir Crit Care Med. 1995 Oct;152(4 Pt 2):S4–12. doi: 10.1164/ajrccm/152.4_Pt_2.S4. [DOI] [PubMed] [Google Scholar]
  25. Empey D. W., Laitinen L. A., Jacobs L., Gold W. M., Nadel J. A. Mechanisms of bronchial hyperreactivity in normal subjects after upper respiratory tract infection. Am Rev Respir Dis. 1976 Feb;113(2):131–139. doi: 10.1164/arrd.1976.113.2.131. [DOI] [PubMed] [Google Scholar]
  26. Emre U., Roblin P. M., Gelling M., Dumornay W., Rao M., Hammerschlag M. R., Schachter J. The association of Chlamydia pneumoniae infection and reactive airway disease in children. Arch Pediatr Adolesc Med. 1994 Jul;148(7):727–732. doi: 10.1001/archpedi.1994.02170070065013. [DOI] [PubMed] [Google Scholar]
  27. Emre U., Sokolovskaya N., Roblin P. M., Schachter J., Hammerschlag M. R. Detection of anti-Chlamydia pneumoniae IgE in children with reactive airway disease. J Infect Dis. 1995 Jul;172(1):265–267. doi: 10.1093/infdis/172.1.265. [DOI] [PubMed] [Google Scholar]
  28. Erntell M., Ljunggren K., Gadd T., Persson K. Erythema nodosum--a manifestation of Chlamydia pneumoniae (strain TWAR) infection. Scand J Infect Dis. 1989;21(6):693–696. doi: 10.3109/00365548909021699. [DOI] [PubMed] [Google Scholar]
  29. Falck G., Heyman L., Gnarpe J., Gnarpe H. Chlamydia pneumoniae (TWAR): a common agent in acute bronchitis. Scand J Infect Dis. 1994;26(2):179–187. doi: 10.3109/00365549409011782. [DOI] [PubMed] [Google Scholar]
  30. Foy H. M., Ochs H., Davis S. D., Kenny G. E., Luce R. R. Mycoplasma pneumoniae infections in patients with immunodeficiency syndromes: report of four cases. J Infect Dis. 1973 Apr;127(4):388–393. doi: 10.1093/infdis/127.4.388. [DOI] [PubMed] [Google Scholar]
  31. Friedman R. L., Lochner J. E., Bigley R. H., Iglewski B. H. The effects of Legionella pneumophila toxin on oxidative processes and bacterial killing of human polymorphonuclear leukocytes. J Infect Dis. 1982 Sep;146(3):328–334. doi: 10.1093/infdis/146.3.328. [DOI] [PubMed] [Google Scholar]
  32. Frydén A., Kihlström E., Maller R., Persson K., Romanus V., Anséhn S. A clinical and epidemiological study of "ornithosis" caused by Chlamydia psittaci and Chlamydia pneumoniae (strain TWAR). Scand J Infect Dis. 1989;21(6):681–691. doi: 10.3109/00365548909021698. [DOI] [PubMed] [Google Scholar]
  33. Garofalo R., Kimpen J. L., Welliver R. C., Ogra P. L. Eosinophil degranulation in the respiratory tract during naturally acquired respiratory syncytial virus infection. J Pediatr. 1992 Jan;120(1):28–32. doi: 10.1016/s0022-3476(05)80592-x. [DOI] [PubMed] [Google Scholar]
  34. Gil J. C., Cedillo R. L., Mayagoitia B. G., Paz M. D. Isolation of Mycoplasma pneumoniae from asthmatic patients. Ann Allergy. 1993 Jan;70(1):23–25. [PubMed] [Google Scholar]
  35. Grayston J. T., Aldous M. B., Easton A., Wang S. P., Kuo C. C., Campbell L. A., Altman J. Evidence that Chlamydia pneumoniae causes pneumonia and bronchitis. J Infect Dis. 1993 Nov;168(5):1231–1235. doi: 10.1093/infdis/168.5.1231. [DOI] [PubMed] [Google Scholar]
  36. Greve J. M., Davis G., Meyer A. M., Forte C. P., Yost S. C., Marlor C. W., Kamarck M. E., McClelland A. The major human rhinovirus receptor is ICAM-1. Cell. 1989 Mar 10;56(5):839–847. doi: 10.1016/0092-8674(89)90688-0. [DOI] [PubMed] [Google Scholar]
  37. Hacker J., Ott M., Wintermeyer E., Ludwig B., Fischer G. Analysis of virulence factors of Legionella pneumophila. Zentralbl Bakteriol. 1993 Apr;278(2-3):348–358. doi: 10.1016/s0934-8840(11)80851-0. [DOI] [PubMed] [Google Scholar]
  38. Hahn D. L., Dodge R. W., Golubjatnikov R. Association of Chlamydia pneumoniae (strain TWAR) infection with wheezing, asthmatic bronchitis, and adult-onset asthma. JAMA. 1991 Jul 10;266(2):225–230. [PubMed] [Google Scholar]
  39. Hammerschlag M. R., Chirgwin K., Roblin P. M., Gelling M., Dumornay W., Mandel L., Smith P., Schachter J. Persistent infection with Chlamydia pneumoniae following acute respiratory illness. Clin Infect Dis. 1992 Jan;14(1):178–182. doi: 10.1093/clinids/14.1.178. [DOI] [PubMed] [Google Scholar]
  40. Henderson F. W., Clyde W. A., Jr, Collier A. M., Denny F. W., Senior R. J., Sheaffer C. I., Conley W. G., 3rd, Christian R. M. The etiologic and epidemiologic spectrum of bronchiolitis in pediatric practice. J Pediatr. 1979 Aug;95(2):183–190. doi: 10.1016/s0022-3476(79)80647-2. [DOI] [PubMed] [Google Scholar]
  41. Holt S., Ryan W. F., Epstein E. J. Severe mycoplasma pneumonia. Thorax. 1977 Feb;32(1):112–115. doi: 10.1136/thx.32.1.112. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Horwitz M. A. Cell-mediated immunity in Legionnaires' disease. J Clin Invest. 1983 Jun;71(6):1686–1697. doi: 10.1172/JCI110923. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Hubbard R. B., Mathur R. M., MacFarlane J. T. Severe community-acquired legionella pneumonia: treatment, complications and outcome. Q J Med. 1993 May;86(5):327–332. [PubMed] [Google Scholar]
  44. Huhti E., Mokka T., Nikoskelainen J., Halonen P. Association of viral and mycoplasma infections with exacerbations of asthma. Ann Allergy. 1974 Sep;33(3):145–149. [PubMed] [Google Scholar]
  45. Husby S., Agertoft L., Mortensen S., Pedersen S. Treatment of croup with nebulised steroid (budesonide): a double blind, placebo controlled study. Arch Dis Child. 1993 Mar;68(3):352–355. doi: 10.1136/adc.68.3.352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Jeffrey R. F., More I. A., Carrington D., Briggs J. D., Junor B. J. Acute glomerulonephritis following infection with Chlamydia psittaci. Am J Kidney Dis. 1992 Jul;20(1):94–96. doi: 10.1016/s0272-6386(12)80325-8. [DOI] [PubMed] [Google Scholar]
  47. Johnston S. L., Pattemore P. K., Sanderson G., Smith S., Lampe F., Josephs L., Symington P., O'Toole S., Myint S. H., Tyrrell D. A. Community study of role of viral infections in exacerbations of asthma in 9-11 year old children. BMJ. 1995 May 13;310(6989):1225–1229. doi: 10.1136/bmj.310.6989.1225. [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Kapikian A. Z., Mitchell R. H., Chanock R. M., Shvedoff R. A., Stewart C. E. An epidemiologic study of altered clinical reactivity to respiratory syncytial (RS) virus infection in children previously vaccinated with an inactivated RS virus vaccine. Am J Epidemiol. 1969 Apr;89(4):405–421. doi: 10.1093/oxfordjournals.aje.a120954. [DOI] [PubMed] [Google Scholar]
  49. Komaroff A. L., Aronson M. D., Schachter J. Chlamydia trachomatis infection in adults with community-acquired pneumonia. JAMA. 1981 Apr 3;245(13):1319–1322. [PubMed] [Google Scholar]
  50. Lebowitz M. D., Burrows B. The relationship of acute respiratory illness history to the prevalence and incidence of obstructive lung disorders. Am J Epidemiol. 1977 Jun;105(6):544–554. doi: 10.1093/oxfordjournals.aje.a112418. [DOI] [PubMed] [Google Scholar]
  51. Leigh M. W., Clyde W. A., Jr Chlamydial and mycoplasmal pneumonias. Semin Respir Infect. 1987 Sep;2(3):152–158. [PubMed] [Google Scholar]
  52. Little J. W., Hall W. J., Douglas R. G., Jr, Mudholkar G. S., Speers D. M., Patel K. Airway hyperreactivity and peripheral airway dysfunction in influenza A infection. Am Rev Respir Dis. 1978 Aug;118(2):295–303. doi: 10.1164/arrd.1978.118.2.295. [DOI] [PubMed] [Google Scholar]
  53. Locksley R. M., Jacobs R. F., Wilson C. B., Weaver W. M., Klebanoff S. J. Susceptibility of Legionella pneumophila to oxygen-dependent microbicidal systems. J Immunol. 1982 Nov;129(5):2192–2197. [PubMed] [Google Scholar]
  54. Macfarlane J. T., Finch R. G., Ward M. J., Macrae A. D. Hospital study of adult community-acquired pneumonia. Lancet. 1982 Jul 31;2(8292):255–258. doi: 10.1016/s0140-6736(82)90334-8. [DOI] [PubMed] [Google Scholar]
  55. Monto A. S., Cavallaro J. J. The Tecumseh study of respiratory illness. II. Patterns of occurrence of infection with respiratory pathogens, 1965-1969. Am J Epidemiol. 1971 Sep;94(3):280–289. doi: 10.1093/oxfordjournals.aje.a121321. [DOI] [PubMed] [Google Scholar]
  56. Morrison R. P., Lyng K., Caldwell H. D. Chlamydial disease pathogenesis. Ocular hypersensitivity elicited by a genus-specific 57-kD protein. J Exp Med. 1989 Mar 1;169(3):663–675. doi: 10.1084/jem.169.3.663. [DOI] [PMC free article] [PubMed] [Google Scholar]
  57. Murphy B. R., Prince G. A., Walsh E. E., Kim H. W., Parrott R. H., Hemming V. G., Rodriguez W. J., Chanock R. M. Dissociation between serum neutralizing and glycoprotein antibody responses of infants and children who received inactivated respiratory syncytial virus vaccine. J Clin Microbiol. 1986 Aug;24(2):197–202. doi: 10.1128/jcm.24.2.197-202.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  58. Nagayama Y., Sakurai N., Yamamoto K., Honda A., Makuta M., Suzuki R. Isolation of Mycoplasma pneumoniae from children with lower-respiratory-tract infections. J Infect Dis. 1988 May;157(5):911–917. doi: 10.1093/infdis/157.5.911. [DOI] [PubMed] [Google Scholar]
  59. Nicholson K. G., Kent J., Ireland D. C. Respiratory viruses and exacerbations of asthma in adults. BMJ. 1993 Oct 16;307(6910):982–986. doi: 10.1136/bmj.307.6910.982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  60. Nielsen S. L., Rønholm E., Sørensen I., Jaeger P., Andersen H. K. Improvement of serological diagnosis of neonatal cytomegalovirus infection by simultaneously testing for specific immunoglobulins E and M by antibody-capture enzyme-linked immunosorbent assay. J Clin Microbiol. 1987 Aug;25(8):1406–1410. doi: 10.1128/jcm.25.8.1406-1410.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  61. Noriega E. R., Simberkoff M. S., Gilroy F. J., Rahal J. J., Jr Life-threatening Mycoplasma pneumoniae pneumonia. JAMA. 1974 Sep 9;229(11):1471–1472. [PubMed] [Google Scholar]
  62. Openshaw P. J. Immunity and immunopathology to respiratory syncytial virus. The mouse model. Am J Respir Crit Care Med. 1995 Oct;152(4 Pt 2):S59–S62. doi: 10.1164/ajrccm/152.4_Pt_2.S59. [DOI] [PubMed] [Google Scholar]
  63. Ostergaard L., Andersen P. L. Etiology of community-acquired pneumonia. Evaluation by transtracheal aspiration, blood culture, or serology. Chest. 1993 Nov;104(5):1400–1407. doi: 10.1378/chest.104.5.1400. [DOI] [PubMed] [Google Scholar]
  64. Ragunathan P. L., Gray J. W., Kenna A. P., Lightfoot N. F. No evidence of Chlamydia trachomatis infection in children with wheeze. Eur J Clin Microbiol Infect Dis. 1995 May;14(5):470–471. doi: 10.1007/BF02114910. [DOI] [PubMed] [Google Scholar]
  65. Rechnitzer C., Kharazmi A. Effect of Legionella pneumophila cytotoxic protease on human neutrophil and monocyte function. Microb Pathog. 1992 Feb;12(2):115–125. doi: 10.1016/0882-4010(92)90114-4. [DOI] [PubMed] [Google Scholar]
  66. Rechnitzer C. Pathogenetic aspects of Legionnaires' disease: interaction of Legionella pneumophila with cellular host defences. APMIS Suppl. 1994;43:1–43. [PubMed] [Google Scholar]
  67. Ridgway G. TWAR and changing respiratory infections. Practitioner. 1990 Aug;234(1493):790–792. [PubMed] [Google Scholar]
  68. Rodgers F. G. The role of structure and invasiveness on the pathogenicity of Legionella. Zentralbl Bakteriol Mikrobiol Hyg A. 1983 Jul;255(1):138–144. [PubMed] [Google Scholar]
  69. Ruuth E., Praz F. Interactions between mycoplasmas and the immune system. Immunol Rev. 1989 Dec;112:133–160. doi: 10.1111/j.1600-065x.1989.tb00556.x. [DOI] [PubMed] [Google Scholar]
  70. Saikku P., Wang S. P., Kleemola M., Brander E., Rusanen E., Grayston J. T. An epidemic of mild pneumonia due to an unusual strain of Chlamydia psittaci. J Infect Dis. 1985 May;151(5):832–839. doi: 10.1093/infdis/151.5.832. [DOI] [PubMed] [Google Scholar]
  71. Seggev J. S., Lis I., Siman-Tov R., Gutman R., Abu-Samara H., Schey G., Naot Y. Mycoplasma pneumoniae is a frequent cause of exacerbation of bronchial asthma in adults. Ann Allergy. 1986 Oct;57(4):263–265. [PubMed] [Google Scholar]
  72. Shah A., Check F., Baskin S., Reyman T., Menard R. Legionnaires' disease and acute renal failure: case report and review. Clin Infect Dis. 1992 Jan;14(1):204–207. doi: 10.1093/clinids/14.1.204. [DOI] [PubMed] [Google Scholar]
  73. Shapiro D. S., Kenney S. C., Johnson M., Davis C. H., Knight S. T., Wyrick P. B. Brief report: Chlamydia psittaci endocarditis diagnosed by blood culture. N Engl J Med. 1992 Apr 30;326(18):1192–1195. doi: 10.1056/NEJM199204303261805. [DOI] [PubMed] [Google Scholar]
  74. Sigurs N., Bjarnason R., Sigurbergsson F., Kjellman B., Björkstén B. Asthma and immunoglobulin E antibodies after respiratory syncytial virus bronchiolitis: a prospective cohort study with matched controls. Pediatrics. 1995 Apr;95(4):500–505. [PubMed] [Google Scholar]
  75. Similä S., Linna O., Lanning P., Heikkinen E., Ala-Houhala M. Chronic lung damage caused by adenovirus type 7: a ten-year follow-up study. Chest. 1981 Aug;80(2):127–131. doi: 10.1378/chest.80.2.127. [DOI] [PubMed] [Google Scholar]
  76. Sims D. G., Gardner P. S., Weightman D., Turner M. W., Soothill J. F. Atopy does not predispose to RSV bronchiolitis or postbronchiolitic wheezing. Br Med J (Clin Res Ed) 1981 Jun 27;282(6282):2086–2088. doi: 10.1136/bmj.282.6282.2086. [DOI] [PMC free article] [PubMed] [Google Scholar]
  77. Street N. E., Schumacher J. H., Fong T. A., Bass H., Fiorentino D. F., Leverah J. A., Mosmann T. R. Heterogeneity of mouse helper T cells. Evidence from bulk cultures and limiting dilution cloning for precursors of Th1 and Th2 cells. J Immunol. 1990 Mar 1;144(5):1629–1639. [PubMed] [Google Scholar]
  78. Svanborg C., Agace W., Hedges S., Linder H., Svensson M. Bacterial adherence and epithelial cell cytokine production. Zentralbl Bakteriol. 1993 Apr;278(2-3):359–364. [PubMed] [Google Scholar]
  79. Thom D. H., Grayston J. T., Campbell L. A., Kuo C. C., Diwan V. K., Wang S. P. Respiratory infection with Chlamydia pneumoniae in middle-aged and older adult outpatients. Eur J Clin Microbiol Infect Dis. 1994 Oct;13(10):785–792. doi: 10.1007/BF02111337. [DOI] [PubMed] [Google Scholar]
  80. Tipirneni P., Moore B. S., Hyde J. S., Schauf V. IgE antibodies to Mycoplasma pneumoniae in asthma and other atopic diseases. Ann Allergy. 1980 Jul;45(1):1–7. [PubMed] [Google Scholar]
  81. Volovitz B., Welliver R. C., De Castro G., Krystofik D. A., Ogra P. L. The release of leukotrienes in the respiratory tract during infection with respiratory syncytial virus: role in obstructive airway disease. Pediatr Res. 1988 Oct;24(4):504–507. doi: 10.1203/00006450-198810000-00018. [DOI] [PubMed] [Google Scholar]
  82. Welliver R. C., Sun M., Rinaldo D., Ogra P. L. Predictive value of respiratory syncytial virus-specific IgE responses for recurrent wheezing following bronchiolitis. J Pediatr. 1986 Nov;109(5):776–780. doi: 10.1016/s0022-3476(86)80692-8. [DOI] [PubMed] [Google Scholar]
  83. Welliver R. C., Wong D. T., Sun M., McCarthy N. Parainfluenza virus bronchiolitis. Epidemiology and pathogenesis. Am J Dis Child. 1986 Jan;140(1):34–40. doi: 10.1001/archpedi.1986.02140150036029. [DOI] [PubMed] [Google Scholar]
  84. Welliver R. C., Wong D. T., Sun M., Middleton E., Jr, Vaughan R. S., Ogra P. L. The development of respiratory syncytial virus-specific IgE and the release of histamine in nasopharyngeal secretions after infection. N Engl J Med. 1981 Oct 8;305(15):841–846. doi: 10.1056/NEJM198110083051501. [DOI] [PubMed] [Google Scholar]
  85. Winn W. C., Jr, Myerowitz R. L. The pathology of the Legionella pneumonias. A review of 74 cases and the literature. Hum Pathol. 1981 May;12(5):401–422. doi: 10.1016/s0046-8177(81)80021-4. [DOI] [PubMed] [Google Scholar]
  86. Winterbauer R. H., Ludwig W. R., Hammar S. P. Clinical course, management, and long-term sequelae of respiratory failure due to influenza viral pneumonia. Johns Hopkins Med J. 1977 Sep;141(3):148–155. [PubMed] [Google Scholar]
  87. Winther B., Farr B., Turner R. B., Hendley J. O., Gwaltney J. M., Jr, Mygind N. Histopathologic examination and enumeration of polymorphonuclear leukocytes in the nasal mucosa during experimental rhinovirus colds. Acta Otolaryngol Suppl. 1984;413:19–24. doi: 10.3109/00016488409128537. [DOI] [PubMed] [Google Scholar]
  88. Yu V. L. Could aspiration be the major mode of transmission for Legionella? Am J Med. 1993 Jul;95(1):13–15. doi: 10.1016/0002-9343(93)90226-f. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES