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Less common etiologic agents of pediatric pneumonia*

Less common etiologic agents of pediatric pneumonia*
Microbial agent Susceptible hosts
Bacteria
Haemophilus influenzae (typeable and nontypeable) Unimmunized (H. influenzae type b)
Moraxella catarrhalis  
Neisseria meningitidis (often group Y)  
Klebsiella spp Immunocompromised hosts, nosocomial pathogen
Escherichia coli Immunocompromised hosts, nosocomial pathogen
Enterobacter spp Immunocompromised hosts, nosocomial pathogen
Pseudomonas aeruginosa Immunocompromised hosts, nosocomial pathogen, cystic fibrosis
Burkholderia cepacia Cystic fibrosis patients
Achromobacter xylosoxidans Cystic fibrosis patients, nosocomial pathogen
Stenotrophomonas maltophilia Cystic fibrosis patients, nosocomial pathogen
Legionella pneumophila Immunocompromised hosts
Pseudomonas pseudomallei Travelers to or residents of endemic areas
Francisella tularensis Exposure to a particular animal reservoir (rabbits) or insect vector; bioterrorist activity
Brucella abortus Exposure to a particular animal reservoir (cattle, goats)
Chlamydia psittaci Exposure to a particular animal reservoir (psittacines – parrots, parakeets, macaws, and virtually all domestic and wild birds)
Leptospira spp Exposure to a particular animal reservoir
Yersinia pestis Exposure to a particular animal reservoir or insect vector (rats); bioterrorist activity
Anaerobic mouth flora (Prevotella spp, Fusobacterium, Bacteroides spp) Aspiration
Mycobacterium tuberculosis Travelers to or residents of endemic areas, contact with known TB, homeless, recent immigrants from endemic areas, prisoners, and HIV-infected individuals
Nontuberculous mycobacterium Cystic fibrosis patients, immunocompromised hosts
Bordetella pertussis Infants, exposure to adult with a cough illness
Fungi
Coccidioides immitis Travelers to or residents of endemic areas (southwest United States)
Histoplasma capsulatum Travelers to or residents of endemic areas (Ohio, Mississippi, and Missouri River valleys); also occurs in Canada, Central America, eastern and southern Europe, parts of Africa, eastern Asia, and Australia
Blastomyces dermatitidis Travelers to or residents of endemic areas (southeastern and central United States and midwestern states bordering the Great Lakes)
Candida spp Nosocomial pathogen, immunocompromised hosts, cystic fibrosis
Aspergillus spp Nosocomial pathogen, immunocompromised hosts, cystic fibrosis
Pneumocystis jiroveci (formerly carinii) Immunocompromised hosts
Rickettsiae
Coxiella burnetii Exposure to a particular animal reservoir (sheep)
Rickettsia rickettsii Exposure to a particular insect vector
Viruses
Rubeola Travelers to or residents of endemic areas
Herpes simplex virus Neonates and immunocompromised hosts
Cytomegalovirus Immunocompromised hosts, first three months after birth
Epstein-Barr virus Immunocompromised hosts
Varicella zoster virus Immunocompromised hosts
Coronavirus (SARS-CoV, MERS-CoV, SARS-CoV-2)  
Enterovirus (D68) Primarily children <5 years, adolescents, and children with asthma
Rubella  
Hantavirus Travelers to or residents of endemic areas, exposure to a particular animal reservoir (mouse droppings)
HIV  
Mumps  
Human bocavirus Primarily children <5 years
Parechovirus Primarily children <5 years
Avian influenza Exposure to birds; travel to affected area
TB: tuberculosis; HIV: human immunodeficiency virus; SARS: severe acute respiratory syndrome; CoV: coronavirus; MERS: Middle East respiratory syndrome.
* Excluding neonatal pneumonia (in infants <28 days of age).
Data from:
  1. Boyer KM. Nonbacterial pneumonia. In: Textbook of Pediatric Infectious Diseases, Feigin BD, Cherry JD, Demmler GJ, Kaplan SL (Eds), WB Saunders, Philadelphia 2004.
  2. Gaston B. Pneumonia. Pediatr Rev 2002; 23:132.
  3. Klein JO. Bacterial pneumonias. In: Textbook of Pediatric Infectious Diseases, Feigin RD, Cherry JD, Demmler GJ, Kaplan SL (Eds), WB Saunders, Philadelphia 2004.
  4. McIntosh K. Community-acquired pneumonia in children. N Engl J Med 2002; 346:429.
  5. Sandora T, Harper MB. Pneumonia in hospitalized children. Pediatr Clin North Am 2005; 52:1059.
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