Symptoms of Mycoplasma Pneumonia in Adolescents
Mycoplasma pneumonia in adolescents typically presents with fever, persistent dry cough, headache, and arthralgia (joint pain), with less common respiratory distress compared to other pneumonias. 1
Key Clinical Presentation
Common Symptoms
- Gradual onset of symptoms (unlike rapid onset in typical bacterial pneumonia)
- Persistent, often irritating dry cough 2
- Fever (usually >38.5°C) 3
- Headache (frequently reported and often prominent) 1
- Arthralgia/myalgia (muscle and joint pain) 1
- Sore throat 4
- Chest pain (especially in older adolescents) 1
- Abdominal pain (reflecting referred pain from diaphragmatic pleura) 1
Respiratory Findings
- Tachypnea (increased respiratory rate)
- Crackles on chest examination 1
- Wheeze in approximately 30% of cases (more common in older children and adolescents) 1
- Less severe respiratory distress compared to other bacterial pneumonias
- Absence of bronchial breathing at onset 1
Distinguishing Features
Mycoplasma pneumonia is often called "walking pneumonia" because:
- Symptoms are generally milder than other pneumonias
- Patients often remain ambulatory despite infection
- Clinical presentation may mimic viral respiratory infections or asthma 1, 5
Important Diagnostic Considerations
- The combination of fever, arthralgia, headache, persistent cough, and crackles in a school-aged child or adolescent strongly suggests Mycoplasma pneumonia 1
- Absence of wheeze increases likelihood of bacterial pneumonia, though Mycoplasma is an exception as it can present with wheeze in about 30% of cases 1
- Mycoplasma pneumonia can be confused with asthma, especially when wheezing is present 1
Age-Related Patterns
- Highest incidence is among school-aged children and adolescents 5
- Second highest incidence is among children under 5 years 5
- Accounts for approximately 43% of community-acquired pneumonia in young adults (17-44 years) 4
Clinical Course
- Symptoms typically develop gradually rather than suddenly 4
- Illness may persist for several weeks if untreated
- Extrapulmonary complications can occur, sometimes with greater severity than the respiratory infection itself 6
Pitfalls and Caveats
- Mycoplasma pneumonia cannot be reliably diagnosed based solely on clinical symptoms and signs 7
- The absence of wheeze, while statistically significant, does not have sufficient diagnostic value alone to guide treatment decisions 7
- Chest pain may be an important diagnostic indicator, with some studies suggesting its presence more than doubles the probability of Mycoplasma infection 7
- Mycoplasma pneumonia can mimic viral respiratory syndromes as well as other bacterial pneumonias 5
Understanding these symptoms helps in recognizing Mycoplasma pneumonia in adolescents, though definitive diagnosis typically requires laboratory confirmation through PCR or serological testing 2.