What is Mycoplasma pneumonia?

From the Guidelines

Mycoplasma pneumonia is a respiratory infection caused by the bacterium Mycoplasma pneumoniae, often referred to as "walking pneumonia" due to its mild symptoms that allow patients to continue their daily activities while infected. This illness primarily affects the lungs and respiratory tract, causing symptoms such as persistent dry cough, fever, fatigue, sore throat, and headache. Unlike other types of pneumonia, Mycoplasma pneumonia develops gradually over 1-3 weeks.

Key Characteristics of Mycoplasma Pneumonia

• It is a common cause of community-acquired atypical pneumonia, as noted in the study by 1.
• The infection is unique because Mycoplasma bacteria lack cell walls, making them naturally resistant to penicillins and other beta-lactam antibiotics that target cell wall synthesis.
• Treatment usually involves antibiotics, with macrolides like azithromycin or doxycycline being potential first-line treatments, although resistance patterns, such as those reported in 1, should be considered.
• Most cases can be managed at home with rest, adequate hydration, and over-the-counter medications for symptom relief.
• Mycoplasma pneumonia is contagious and spreads through respiratory droplets when infected people cough or sneeze, with outbreaks commonly occurring in crowded settings like schools and military barracks.

Diagnosis and Management

• The diagnosis of Mycoplasma pneumonia can be challenging due to its nonspecific symptoms and the lack of a definitive diagnostic test, as discussed in 1 and 1.
• Antibiotic administration for treatment of suspected bacterial pneumonia is empirical and is dictated by the known or most likely inciting organism, with consideration of patient age and clinical status, as outlined in 1.
• The choice of antibiotic should take into account the potential for resistance, such as the increased macrolide resistance reported in some areas, especially in Asia 1.

Prevention and Public Health

• Preventing the spread of Mycoplasma pneumonia involves practicing good hygiene, such as frequent handwashing and avoiding close contact with individuals who are infected.
• Outbreaks can be managed through public health measures, including education on prevention and the use of appropriate antibiotics for treatment, as discussed in 1.

From the FDA Drug Label

Mycoplasma pneumoniae The FDA drug label does not provide a definition or description of what Mycoplasma pneumonia is, but it does mention that Mycoplasma pneumoniae is a type of bacteria that can cause infections, including community-acquired pneumonia.

• Mycoplasma pneumoniae is listed as one of the microorganisms that levofloxacin has in vitro activity against 2, 2.
• Mycoplasma pneumoniae is also listed as one of the microorganisms that azithromycin is effective against in the treatment of community-acquired pneumonia 3. However, the label does not provide information on what Mycoplasma pneumonia is.

From the Research

Definition and Causes of Mycoplasma Pneumonia

• Mycoplasma pneumonia is a type of community-acquired respiratory tract infection caused by the bacterium Mycoplasma pneumoniae 4.
• It is a common cause of pneumonia, particularly in school-aged children and young adults, and can occur both endemically and epidemically worldwide 4, 5.
• The disease can present with symptoms such as cough, fever, chills, headache, and malaise, and can be suspected when a patient presents with a segmental or subsegmental pulmonary infiltrate and a normal or slightly elevated white blood cell count 5.

Clinical Presentation and Diagnosis

• The clinical presentation of Mycoplasma pneumonia can vary, and the disease can be difficult to diagnose due to its slow-growing pattern and lack of pathognomonic clinical or radiographic presentation 5, 6.
• The diagnosis is typically made based on a combination of epidemiologic, clinical, laboratory, and radiographic data, and can be confirmed by the detection of IgM antibodies against M. pneumoniae 7, 6.
• The disease can also present with extrapulmonary manifestations, such as dermatologic, neurological, cardiac, renal, and pulmonary complications 8, 7.

Treatment and Complications

• The treatment of Mycoplasma pneumonia typically involves the use of antibiotics, such as macrolides, tetracyclines, and fluoroquinolones 4, 5, 7, 6.
• However, the emergence of macrolide resistance has become a significant concern, and alternative antibiotic treatments may be required in cases of resistance 4.
• Mycoplasma pneumonia can also be associated with severe complications, such as diffuse alveolar hemorrhage, and can be life-threatening in small children, especially if left untreated or if treatment is delayed 7, 6.