From the Guidelines
Mycoplasma pneumonia is a type of lung infection caused by the bacterium Mycoplasma pneumoniae, typically presenting with mild symptoms and often referred to as "walking pneumonia". The infection is usually characterized by a persistent dry cough, fever, fatigue, and sometimes chest pain, developing gradually over a period of 1-3 weeks 1.
Key Characteristics
- The symptoms of Mycoplasma pneumonia are typically milder than other forms of pneumonia, allowing many patients to continue their daily activities.
- The infection is highly contagious and spreads through respiratory droplets, often affecting younger adults and children in close-contact settings like schools or military barracks.
- Mycoplasma pneumonia doesn't usually respond to common antibiotics like penicillin, instead, it's typically treated with macrolide antibiotics such as azithromycin or clarithromycin, usually for a 5-7 day course 1.
Treatment and Prevention
- Macrolide antibiotics, such as azithromycin, are the recommended treatment for Mycoplasma pneumonia, especially in outpatient settings 1.
- Proper diagnosis and treatment are important to prevent complications and reduce transmission.
- The use of fluoroquinolones is discouraged in ambulatory patients with CAP without comorbid conditions, risk factors for DRSP, or recent antimicrobial use, due to concerns about resistance development 1.
Important Considerations
- Comorbidities or recent antimicrobial therapy increase the likelihood of infection with DRSP and enteric gram-negative bacteria, requiring alternative therapeutic options 1.
- High-dose amoxicillin or amoxicillin-clavulanate is preferred for patients with comorbidities, as it targets 93% of S. pneumoniae 1.
From the Research
Definition and Overview of Mycoplasma pneumoniae Infection
- Mycoplasma pneumoniae is a unique bacterium that causes a range of illnesses in both children and adults, including respiratory and non-respiratory conditions 2.
- The severity of the disease is related to the host immune response, and extrapulmonary complications can occur due to direct invasion or autoimmune response 2, 3.
- Mycoplasma pneumoniae infections can cause pneumonia, as well as other respiratory syndromes such as bronchitis, bronchiolitis, pharyngitis, and croup, which can mimic viral respiratory syndromes 4.
Clinical Manifestations and Complications
- The infection can affect multiple organ systems, including the skin, central nervous system, cardiovascular system, hematopoietic system, kidneys, and musculoskeletal system 3, 5.
- Extrapulmonary manifestations can be more severe and clinically important than the primary respiratory infection, and may include dermatologic, neurological, cardiac, renal, and pulmonary complications 2, 4.
- Immune thrombocytopenia purpura has been reported as a rare hematological manifestation of Mycoplasma infection 3.
Diagnosis and Treatment
- Diagnosis of Mycoplasma pneumoniae infection can be challenging due to the lack of constant findings in physical exams, laboratory, or radiological assessments, and the need for specific diagnostic tools 6.
- Effective management of M. pneumoniae infections can usually be achieved with macrolides, tetracyclines, or fluoroquinolones, and anti-Mycoplasma therapy can lead to complete resolution of symptoms and recovery from complications such as thrombocytopenia 2, 3.