Key messages

• Treatment of atypical pneumonia is mainly symptomatic, with adequate ventilation with end-expiratory pressure if necessary.

• Antibiotics active against intracellular pathogens must be retained in the cell and be able to express their activity in the intracellular medium where the bacteria are located.

• Legionellosis is by far the most common cause of life-threatening atypical pneumonia.

• Probabilistic treatment of community-acquired pneumonia must include treatment active against Legionella species, namely erythromycin or the fluoroquinolones.

• Most cases of viral pneumonia admitted to the intensive care unit require only symptomatic treatment.

• It must be remembered that bacterial superinfection with Staphylococcus aureus, Staphylococcus pneumoniae, or Hemophilus influenzae frequently accompanies viral pneumonia, particularly influenza pneumonia.

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