Abstract: Atypical pneumonias in children represent a diagnostic and therapeutic challenge 
due to their diverse etiology and often non-specific clinical presentation. Unlike typical 
bacterial pneumonias, they are frequently caused by pathogens such as Mycoplasma 
pneumoniae, Chlamydia pneumoniae, Legionella pneumophila, and certain viruses, and may 
present with milder symptoms that can delay diagnosis and treatment. This study aims to review 
and analyze the current scientific literature regarding the clinical and diagnostic 
characteristics of atypical pneumonias in pediatric patients. A structured literature review was 
conducted using scientific databases including PubMed, Scopus, and Google Scholar. Articles 
published in the last 10 years that focused on the etiology, clinical manifestations, diagnostic 
approaches, and treatment of atypical pneumonias in children were included. The most 
common causative agents identified were M. pneumoniae and C. pneumoniae, particularly in 
school-aged children. Clinical features typically include persistent dry cough, low-grade fever, 
and fatigue, with minimal auscultatory findings. Diagnosis often requires molecular testing 
such as PCR, as imaging and serology may not be definitive. Macrolide antibiotics remain the 
first-line therapy, although emerging resistance has been reported. Timely recognition and 
accurate diagnosis of atypical pneumonias in children are critical for effective treatment. 
Enhanced awareness among clinicians and the broader use of molecular diagnostics can 
significantly improve patient outcomes. 
Keywords: atypical pneumonia, children, Mycoplasma pneumoniae, clinical diagnosis, PCR, 
macrolides, pediatric respiratory infections 

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