Symptoms may be relieved by sitting down (flexing the spine) or even by walking while leaning over (flexion of the spine) a shopping cart.The ability to ride a stationary bike for a prolonged period of time differentiates neurogenic claudication from vascular claudication. Weakness is also a prominent feature of spinal claudication that is not usually present in intermittent claudication. Treatment
Blocking agents of the adrenoceptors alpha 1/alpha 2 are typically used to treat the effects of the vasoconstriction associated with vascular claudication. Cilostazol (trade name: Pletal) is FDA approved for intermittent claudication. It is contraindicated in patients with heart failure, and improvement of symptoms may not be evident for two to three weeks.Neurogenic claudication can be treated surgically with spinal decompression. Prognosis
The prognosis for patients with peripheral vascular disease due to atherosclerosis is poor; patients with intermittent claudication due to atherosclerosis are at increased risk of death from cardiovascular disease (e.g. heart attack), because the same disease that affects the legs is often present in the arteries of the heart.The prognosis for neurogenic claudication is good if the cause of it can be addressed surgically. References


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Cause
The most common causative organisms are (often intracellular living) bacteria:
Chlamydia pneumoniae
Mild form of pneumonia with relatively mild symptoms. Chlamydia psittaci
Causes psittacosis. Coxiella burnetii
Causes Q fever. Francisella tularensis
Causes tularemia. Legionella pneumophila
Causes a severe form of pneumonia with a relatively high mortality rate, known as legionellosis or Legionnaires disease. Mycoplasma pneumoniae
 Usually occurs in younger age groups and may be associated with neurological and systemic (e.g. rashes) symptoms.Atypical pneumonia can also have a fungal, protozoan or viral cause.In the past, most organisms were difficult to culture. However, newer techniques aid in the definitive identification of the pathogen, which may lead to more individualized treatment plans. Viral
Known viral causes of atypical pneumonia include respiratory syncytial virus (RSV), influenza A and B, parainfluenza, adenovirus, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), COVID-19
and measles. Diagnosis
Chest radiographs (X-ray photographs) often show a pulmonary infection before physical signs of atypical pneumonia are observable at all. This is occult pneumonia. In general, occult pneumonia is rather often present in patients with pneumonia and can also be caused by Streptococcus pneumoniae, as the decrease of occult pneumonia after vaccination of children with a pneumococcal vaccine suggests.Infiltration commonly begins in the perihilar region (where the bronchus begins) and spreads in a wedge- or fan-shaped fashion toward the periphery of the lung field. The process most often involves the lower lobe, but may affect any lobe or combination of lobes. Epidemiology
Mycoplasma is found more often in younger than in older people. Older people are more often infected by Legionella.