Symptoms of Mycoplasma pneumoniae Infection
Mycoplasma pneumoniae infection typically presents with fever, arthralgia, headache, cough and crackles, especially in school-aged children and adolescents. 1
Common Clinical Presentation
Respiratory Symptoms
- Cough - Often dry, persistent, and irritating 2, 3
- Sore throat - Common early symptom 2
- Crackles on chest examination 1
- Wheeze - Present in approximately 30% of cases, more common in older children 1
- Chest pain - May occur, especially in older children 1
Systemic Symptoms
- Fever - Usually present, often low-grade 2, 4
- Headache - Frequently reported 1, 3
- Arthralgia (joint pain) - Characteristic symptom 1
- Malaise - General feeling of unwellness 5
- Muscle pain - Can accompany other symptoms 3
Age-Specific Presentation
- School-aged children and adolescents - Most typical presentation with the full constellation of symptoms 1, 6
- Young children - May have less specific symptoms, making diagnosis more challenging
Distinguishing Features
- Gradual onset - Symptoms typically develop gradually and can progress over weeks 2, 5
- Abdominal pain - May occur in older children due to referred pain from the diaphragmatic pleura 1
- Absence of bronchial breathing and pleural effusion at the onset of symptoms 1
- Walking pneumonia - Often mild enough that patients remain ambulatory despite infection 2
Diagnostic Challenges
- Mycoplasma pneumonia can be confused with asthma, especially when wheezing is present 1
- The clinical presentation can mimic viral respiratory syndromes 6
- Symptoms may resemble other bacterial pneumonias (pneumococcal, staphylococcal) 1
Complications
While most cases are mild, Mycoplasma pneumoniae can occasionally cause serious complications:
- Diffuse alveolar hemorrhage - Rare but potentially life-threatening 5
- Extrapulmonary manifestations - Can affect multiple organ systems 4
- Neurological complications - In severe cases 3
- Cardiac, renal, and dermatologic complications - Less common 6
Clinical Pearls
- The combination of fever, arthralgia, headache, cough, and crackles in a school-aged child strongly suggests Mycoplasma pneumoniae infection 1
- The absence of wheeze in a febrile child with respiratory symptoms increases the likelihood of bacterial pneumonia, but Mycoplasma should still be considered, especially if wheeze is present in an older child 1
- Mycoplasma infections occur in 4-5 year epidemic cycles, which may help with diagnosis during outbreak periods 4
- Most cases are treated on an outpatient basis, but severe presentations requiring hospitalization can occur 6, 5
The recognition of these characteristic symptoms is crucial for early diagnosis and appropriate treatment, which typically involves macrolide antibiotics such as azithromycin for uncomplicated cases 2, 3.