It is no longer felt that atypical (viral) pneumonia is always as innocuous as it was originally described. Many patients have experienced recurring episodes of this disease over a period of several years. In some the symptoms have continued unabated; a productive cough has developed, and the presence of bronchiectasis has been confirmed by bronchographic examination. Other patients have had residual ulcerative tracheobronchitis associated with hemoptysis and production of sputum. These patients may show roentgenographic evidence of bronchial and bronchiolar dilatation and occlusion, atelectasis or obstructive emphysema. In others the convalescence has been prolonged and characterized by neurasthenia, chronic cough, production of sputum, pain in the chest, generalized weakness, easy fatigability, occasional hemoptysis, loss of weight or failure to regain previous weight lost, elevated sedimentation rate and low grade fever.
Twenty-nine of 150 patients having bronchoscopic examinations during the first six months of 1944 were found to have ulcerative lesions