ABSTRACT
The true incidence of Legionella pneumophilia; Mycoplasma pneumoniae; Chlamydophila pneumoniae and Coxiella burnetti; the so called 'atypical' pathogens that cause adult community acquired pneumonia in Southern Africa is unknown. Although there are a lack of community-based studies; hospital-based studies suggest that the incidence may be up to 30 in patients admitted; but not requiring an intensive care unit. A lack of specific clinical features that differentiate atypical pathogens; plus the lack of reliable; simple diagnostics compound the uncertainty as to the contribution of atypical pathogens to the sum total of community acquired pneumonias in Southern Africa. Without reliable diagnostic tests; macrolide/azalide antibiotics are widely used for inpatients with pneumonia potentially fuelling the rise of antibiotic resistance to macrolides in other bacteria