Mycoplasma pneumoniae
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Epidemiology
- humans are the only known reservoir
- spread of infection is person to person
- infections occur in endemic & epidemic forms
- epidemics are more common in summer & autumn
- more common in children & young adults
- 20% of all community-acquired pneumonia
- outbreak affecting 83 students at a Georgia University in 2012[5]
- outbreak in long-term care facility in Nebraska 2014[6]
- common infection in closed populations[6] (residential facilities, boarding schools, military barracks ...)
- spike of cases fall of 2024 in a Missouri public school district[8]
Clinical manifestations
- incubation period is 2-3 weeks
- fever (85%)
- coryza
- pharyngitis (50%)
- bullous myringitis (20%)
- pulmonary manifestations
- tracheobronchitis
- pneumonia occurs in 3-10% of infected patients
- interstitial pneumonia
- bronchiolitis
- nonproductive cough (> 90%)
- scattered crackles are heard throughout both lung fields[3]
- sharp chest pain with deep breaths
- hemolytic anemia
- erythema multiforme
- erythematous, targetoid lesions present on arms, legs, & palms[3]
- hepatitis
- Guillain-Barre syndrome
- headache, malaise[3]
Laboratory
- Mycoplasma pneumoniae serology
- complement fixation serology
- 4 fold increase in titer in 50-80% of patients
- complement fixation serology
- Mycoplasma pneumoniae DNA, Mycoplasma pneumoniae rRNA
- Mycoplasma pneumoniae culture*
- respiratory tract secretions
- middle ear
- cerebrospinal fluid (CSF)
- cold agglutinins
- > 1:64 in 50% of patients
- appear during 2nd to 3rd week after onset of symptoms
- titer decreases to insignificant levels by 4-6 weeks
- abnormal liver function tests
- platelet count: thrombocytopenia
- see ARUP consult[4]
* difficult to culture
Radiology
- chest X-ray
- unilateral bronchopneumonia
- lower lobe involvement (65%)
- pleural effusion (5%)
- bilateral patchy opacities[3]
Management
- macrolide
- tetracycline or doxycycline
- fluoroquinolone
- resistance to beta-lactam antibiotics
More general terms
Additional terms
References
- ↑ Manual of Medical Therapeutics, 28th edition, Ewald & McKenzie (eds) Little, Brown & Co, 1995, pg 301
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 795
- ↑ 3.0 3.1 3.2 3.3 3.4 Medical Knowledge Self Assessment Program (MKSAP) 15, 18. American College of Physicians, Philadelphia 2009, 2018.
Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025 - ↑ 4.0 4.1 ARUP Consult: Mycoplasma pneumoniae The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/mycoplasma-pneumoniae
- ↑ 5.0 5.1 Centers for Disease Control and Prevention (CDC) Mycoplasma pneumoniae outbreak at a university - Georgia, 2012. MMWR Morb Mortal Wkly Rep 2013 Aug 2; 62:603. <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/23903594 <Internet> http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6230a2.htm
- ↑ 6.0 6.1 6.2 Hastings DL et al. Mycoplasma pneumoniae outbreak in a long-term care facility
Nebraska, 2014. MMWR Morb Mortal Wkly Rep 2015 Mar 27; 64:296 <PubMed> PMID: https://pubmed.ncbi.nlm.nih.gov/25811678 <Internet> http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6411a2.htm - ↑ 7.0 7.1 Li T, Lee N. Mycoplasma pneumoniae-Associated Mucositis. N Engl J Med 2018; 379:1262. Sept 27, 2018 PMID: https://pubmed.ncbi.nlm.nih.gov/30257151 https://www.nejm.org/doi/full/10.1056/NEJMicm1614484
- ↑ 8.0 8.1 Almendares OM et al. Notes from the Field: School-based surveillance of Mycoplasma pneumoniae trends and impact on school attendance by students and staff members - Missouri, fall 2024. MMWR Morb Mortal Wkly Rep 2024 Dec 19; 73:1144. PMID: https://pubmed.ncbi.nlm.nih.gov/39700068 PMCID: PMC11658397 Free PMC article https://www.cdc.gov/mmwr/volumes/73/wr/mm7350a3.htm