Clinical Features of Various Pneumonias ======================================= þ Pneumonia with Bullous Myringitis: - Bullae on the tympanic membrane (bullous myringitis) is highly suggestive of infection with Mycoplasma pneumoniae in a patient with pneumonia. - But also found in other kinds of otitis (staph, H. flu). þ Pneumonia in elderly patient, severely toxic, high fever, headache, myalgias, severe weakness, malaise, and watery diarrhea: - Legionella. þ Pneumonia in a patient who is recovering from a viral infection and presents with a pneumonia complicated by a pulmonary abscess and a pneumothorax: - Staph þ Pneumonia in a kid who has a rash: - Mycoplasma pneumoniae often causes a concomitant rash. This is often an erythematous maculopapular rash, primarily on the trunk. However, the patient may also present with Erythema multiforme or Stevens-Johnson syndrome. Reference: Tintinalli 3rd ed. p 506 þ Pleuritic Chest Pain: - S. pneumoniae causes pleuritic chest pain in 70% of patients and - K. pneumoniae causes pleuritic chest pain in 80% of patients, while - pleuritic chest pain is only seen occasionally in those infected with H. influenzae. Ref: Tintinalli 3rd ed. p 265