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Mycoplasma Pneumonia
Primary Atypical Pneumonia (pap) Due to Mycoplasma

Presentation

Bilateral peribronchial and perivascular interstitial infiltrates were most frequently seen in the present patients. [ncbi.nlm.nih.gov]

Entire Body System

  • Fever

    Interleukin-6 serum levels in mycoplasma pneumonia patients with fever for more than 3 days (41.98 +/- 67.46 [SD] pg/mL) were significantly higher than those in patients with fever < or = 3 days (10.01 +/- 11.74 pg/mL, p < 0.05). [ncbi.nlm.nih.gov]

    Clinical findings Incubation ± 3 weeks; insidious onset of fever, malaise, headache, myalgia, low-grade fever, cough, chest pain and respiratory disease, from asymptomatic to rhinitis, pharyngitis, tracheobronchitis and pneumonia. [medical-dictionary.thefreedictionary.com]

    […] with the duration of fever before hospitalization ( r = 0.377, P = 0.002) ( Fig. 3 ). [cvi.asm.org]

    The patient reported fevers ranging from 38.4°C to 39.3°C (101.1°–102.7°F) with the highest fevers occurring at night. Her fever would respond to ibuprofen and acetaminophen, but would not completely resolve. [hindawi.com]

  • Pain

    PNEUMONIA and pulmonary embolism may present clinically in a similar fashion.1 Hemoptysis, dyspnea, tachypnea, pleuritic chest pain, hypoxemia, respiratory alkalosis, and fever are features commonly seen in both diseases. [jamanetwork.com]

    Here, we report an unusual case of a patient who presented with fever and abdominal pain, but without pulmonary manifestations. The laboratory work-up demonstrated a hepatocellular pattern of acute hepatitis caused by M. pneumonia infection. [ncbi.nlm.nih.gov]

    Clinical findings Incubation ± 3 weeks; insidious onset of fever, malaise, headache, myalgia, low-grade fever, cough, chest pain and respiratory disease, from asymptomatic to rhinitis, pharyngitis, tracheobronchitis and pneumonia. [medical-dictionary.thefreedictionary.com]

    Central nervous system (CNS) involvement Gastrointestinal manifestations, eg, nausea, vomiting, and diarrhea Joint pain If indications are not present, testing for Mycoplasma pneumoniae is not indicated as this is usually a mild, self-limited disease [arupconsult.com]

  • Anemia

    This case demonstrates that, even in patients with clinically mild pneumonia, M. pneumoniae may be the cause of severe anemia. [ncbi.nlm.nih.gov]

    Additionally, it is widely accepted that infection with this organism can result in a variety of extrapulmonary sequelae including septic arthritis, hemolytic anemia, dermatological, renal, central nervous system and cardiac complications. [uniprot.org]

    […] presentations run the gamut from upper respiratory (usually self-limited) and lower respiratory tract involvement (pneumonia) to unusual manifestations including nervous system disease (encephalitis, cerebellar ataxia, transverse myelitis), hemolytic anemia [mdedge.com]

  • Malaise

    Clinical findings Incubation ± 3 weeks; insidious onset of fever, malaise, headache, myalgia, low-grade fever, cough, chest pain and respiratory disease, from asymptomatic to rhinitis, pharyngitis, tracheobronchitis and pneumonia. [medical-dictionary.thefreedictionary.com]

    The diagnosis is suspected when the patient presents with symptoms suggesting primary atypical pneumonia including cough, fever, chills, headache, and malaise in association with a segmental or subsegmental pulmonary infiltrate(s), the white blood cell [ncbi.nlm.nih.gov]

    Infection occurs in 3 to 4 year cycles in temperate climates and chiefly affects children and young adults, causing an atypical pneumonia characterised by an influenza-like respiratory illness of gradual onset with headache, malaise, fever and cough [gpnotebook.co.uk]

    Tabs Content Clinical Overview Diagnosis Indications for Testing Mild illness consisting of upper or lower respiratory illness with gradual onset of Malaise Fever Headache Sore throat Persistent cough Atypical pneumonia appearance on chest x-ray (patchy [arupconsult.com]

  • Fatigue

    …” I have all the official documents to prove that mycoplasma is the disease agent in chronic fatigue syndrome/fibromyalgia as well as in AIDS, multiple sclerosis and many other illnesses. [frequencyfoundation.com]

    Common symptoms of pneumonia include: Cough that may produce mucus Fever and chills Shortness of breath Chest pain Fatigue Children younger than 5 years old often do not run a fever when they have an illness caused by M. pneumoniae. [cdc.gov]

    Mycoplasma have been linked with several chronic diseases, including chronic fatigue syndrome, fibromyalgia syndrome, gulf war syndrome, and rheumatoid arthritis. [bacmap.wishartlab.com]

    Symptoms might include a bothersome and long-lasting cough (this is most common), fatigue, sore throat, hoarseness, low-grade fever, headache, loss of appetite, chest pain, and, less commonly, a bumpy red skin rash. [kidshealth.org]

    If you have Lyme disease, fibromyalgia, chronic fatigue, autoimmune disease, or possibly any other chronic illness, however…it is a microbe you should know about. [rawlsmd.com]

Respiratoric

  • Cough

    The aim of this study was to clarify cough sensitivity in Mycoplasma pneumonia, which is a well known acute lower respiratory infection with persistent nonproductive cough. [ncbi.nlm.nih.gov]

    It is characterized by a 9- to 12-day incubation period and followed by symptoms of an upper respiratory infection, dry cough, and fever. Also called Eaton agent pneumonia, primary atypical pneumonia, walking pneumonia. [medical-dictionary.thefreedictionary.com]

    DO NOT take cough medicines without first talking to your provider. Cough medicines may make it harder for your body to cough up the extra sputum. Drink plenty of fluids to help loosen secretions and bring up phlegm. Get a lot of rest. [account.allinahealth.org]

  • Pleural Effusion

    The possibility of Mycoplasma pneumonia should not be dismissed merely because of the severity of the illness or the presence of pleural effusions. [ncbi.nlm.nih.gov]

    Pleural effusions were seen in seven patients (17%), and all effusions occurred on the left side except for bilateral effusions in one patient. [pubs.rsna.org]

  • Dry Cough

    Although dry cough was observed in all patients during Mycoplasma pneumonia, cough sensitivity in the acute phase [capsaicin: 19.8 (GSEM, 0.214) microM, tartaric acid: 0.26 (GSEM, 0.356) M] were not enhanced compared with those in both control subjects [ncbi.nlm.nih.gov]

    Patients usually do not have severe shortness of breath, high fever, and a productive cough with MP. They more commonly have low-grade fever, dry cough, mild shortness of breath especially with exertion, and fatigue. [healthline.com]

  • Persistent Cough

    These results suggest that ECP may work as a factor causing a persistent cough similar to asthma in children with Mycoplasma pneumonia. [ncbi.nlm.nih.gov]

    5-7 days – cough may become paroxysmal and nocturnal Cough may persist several weeks following resolution of constitutional symptoms Pleural effusions more common in severe disease Extrapulmonary manifestations of M. pneumoniae infection Syndromes caused [arupconsult.com]

    Signs and symptoms include chest pain, persistent cough, fever and/or a sore throat. Complications are rare, but it is important to know the risks. [livestrong.com]

  • Productive Cough

    cough Physical exam non-productive cough bilateral wheezing may be heard on auscultation macropapular or vesicular rash Imaging Chest radiography patchy or diffuse interstitial infiltrates chest radiograph often looks more severe than the patient’s actual [step1.medbullets.com]

    Symptoms develop gradually over several days and include fever, non-productive cough, headache and myalgia. Often it is accompanied by pharyngitis, rhinitis, tracheobronchitis and otitis. [en.vircell.com]

    The inactive cilia of the epithelium cells produce non-productive coughs, fever and sore throat. It also causes an immune repose monopolizing the immune systems but through antigenic variations it capable of avoiding being phagocytized. [web.uconn.edu]

    On hospital day 5, the patient developed a mild productive cough. Her Mycoplasma pneumonia (MP) IgM was high, confirming the diagnosis of MP induced FUO. [hindawi.com]

Cardiovascular

  • Chest Pain

    PNEUMONIA and pulmonary embolism may present clinically in a similar fashion.1 Hemoptysis, dyspnea, tachypnea, pleuritic chest pain, hypoxemia, respiratory alkalosis, and fever are features commonly seen in both diseases. [jamanetwork.com]

    Clinical findings Incubation ± 3 weeks; insidious onset of fever, malaise, headache, myalgia, low-grade fever, cough, chest pain and respiratory disease, from asymptomatic to rhinitis, pharyngitis, tracheobronchitis and pneumonia. [medical-dictionary.thefreedictionary.com]

    and fever Advanced infection Dry, nonproductive cough occurs 3-5 days after onset of initial nonspecific symptoms Cough may produce mucopurulent sputum later in illness May be accompanied by chills, chest pain, shortness of breath, nausea, vomiting, [arupconsult.com]

    Common symptoms of pneumonia include: Cough that may produce mucus Fever and chills Shortness of breath Chest pain Fatigue Children younger than 5 years old often do not run a fever when they have an illness caused by M. pneumoniae. [cdc.gov]

Musculoskeletal

  • Arthritis

    Another of the symptoms that can accompany CCP is arthritis, discussed below. There are some forms of the disease which show no respiratory signs, but merely weakness and a high fever (septicemia, see below). [articles.extension.org]

    Patient had history of chronic obstructive pulmonary disease (COPD) on home oxygen, bronchiectasis, rheumatoid arthritis (on methotrexate and leflunomide), treated pulmonary tuberculosis and 30-pack-year smoking. [ncbi.nlm.nih.gov]

    Additionally, it is widely accepted that infection with this organism can result in a variety of extrapulmonary sequelae including septic arthritis, hemolytic anemia, dermatological, renal, central nervous system and cardiac complications. [uniprot.org]

    Mycoplasma have been linked with several chronic diseases, including chronic fatigue syndrome, fibromyalgia syndrome, gulf war syndrome, and rheumatoid arthritis. [bacmap.wishartlab.com]

    Chronic Mycoplasma infections have been implicated in the pathogenesis of rheumatoid arthritis and other rheumatological diseases. [en.wikipedia.org]

  • Myalgia

    Clinical findings Incubation ± 3 weeks; insidious onset of fever, malaise, headache, myalgia, low-grade fever, cough, chest pain and respiratory disease, from asymptomatic to rhinitis, pharyngitis, tracheobronchitis and pneumonia. [medical-dictionary.thefreedictionary.com]

    Two weeks prior to her presentation she was seen by her primary care physician for flu‐like symptoms, including myalgias, subjective fevers, nonproductive cough, and malaise. [journalofhospitalmedicine.com]

    Symptoms develop gradually over several days and include fever, non-productive cough, headache and myalgia. Often it is accompanied by pharyngitis, rhinitis, tracheobronchitis and otitis. [en.vircell.com]

    Clinical features are an initial nonproductive cough followed by the production of watery or mucoid sputum, fever, rhinorrhea, chest pain, and generalized myalgia. [histopathology-india.net]

    Erythematous macropapular and vesicular rashes (25%), nonspecific myalgia, arthralgias and polyarthropathies (14%), cardiac, gastrointestinal, renal complications, and ears symptoms may also occur. [canada.ca]

Neurologic

  • Headache

    Interestingly, in juveniles, the most common presenting symptom was headache [11], similar to our patient. [hindawi.com]

    Patients suffered from abrupt onset of headache, shaking chills, and severe malaise, followed by fever and cough. Only 2 % required hospitalization. [web.uconn.edu]

    Clinical findings Incubation ± 3 weeks; insidious onset of fever, malaise, headache, myalgia, low-grade fever, cough, chest pain and respiratory disease, from asymptomatic to rhinitis, pharyngitis, tracheobronchitis and pneumonia. [medical-dictionary.thefreedictionary.com]

    Headaches: find out what treatments are available. X-ray examination: is X-ray radiation dangerous? Antibiotics: find information about the different medicines for infections. [netdoctor.co.uk]

    The diagnosis is suspected when the patient presents with symptoms suggesting primary atypical pneumonia including cough, fever, chills, headache, and malaise in association with a segmental or subsegmental pulmonary infiltrate(s), the white blood cell [ncbi.nlm.nih.gov]

  • Guillain-Barré Syndrome

    Mycoplasma atypical pneumonia can be complicated by Stevens–Johnson syndrome, autoimmune hemolytic anemia, cardiovascular diseases, encephalitis, or Guillain–Barré syndrome. [en.wikipedia.org]

    Mycoplasma pneumoniae can also trigger Guillain-Barré syndrome (GBS) in infected individuals. In this case, antibodies formed against Mycoplasma not only attack it but also the outer layer of the body’s own nerve cells. [microbeonline.com]

    Samukawa M, Hamada Y, Kuwahara M, Takada K, Hirano M, et al. (2013) Clinical features in Guillain-Barré syndrome with anti-Gal-C antibody. J Neurol Sci 337: 55–60. [journals.plos.org]

Workup

An extensive autoimmune workup was negative and the infectious workup (Table 1) revealed no source. She complained of worsening EN extending to her thighs, a mild productive cough, and a persistent headache. [hindawi.com]

The results of a full uveitis workup were negative for antinuclear antibody, rheumatoid factor, antineutrophil cytoplasmic antibody, HLA-B27, angiotensin-converting enzyme, Lyme disease, syphilis, and B henselae. [jamanetwork.com]

This case exemplified what is an adequate diagnostic workup for a patient with mucopolysaccharidosis. [pediatrics.aappublications.org]

The routine diagnostic workup of M. pneumoniae encephalitis should therefore aim for the detection of M. pneumoniae antibodies in both CSF and serum, in addition to M. pneumoniae PCR in CSF. [journals.plos.org]

X-Ray

  • Pulmonary Infiltrate

    Pulmonary infiltrates visible on chest x-ray films may resemble those of bacterial or viral pneumonia and may persist for 3 weeks in untreated cases. [medical-dictionary.thefreedictionary.com]

    In 1944, Eaton discovered that sputum and lung tissue from such cases contained an agent that could pass through 45 µm filters permeable to viruses but not bacteria and that caused focal pulmonary infiltrates in rodents ( Eaton et al 1944 ). [medlink.com]

    When the infection progresses to involve the lower respiratory tract, atypical pneumonia with bilateral diffuse pulmonary infiltrates is most common. [cancertherapyadvisor.com]

  • Chest X-Ray Abnormal

    Another study by Puljiz et al.[40] found that the commonest chest x-ray abnormality was interstitial infiltrate in 90.48% followed by alveolar infiltrates in 8.84% cases. Pleural effusion was detected in 13 patients (8.84%). [ncbi.nlm.nih.gov]

    Another study by Puljiz et al. [40] found that the commonest chest x-ray abnormality was interstitial infiltrate in 90.48% followed by alveolar infiltrates in 8.84% cases. Pleural effusion was detected in 13 patients (8.84%). [lungindia.com]

  • X-Ray Abnormal

    Another study by Puljiz et al.[40] found that the commonest chest x-ray abnormality was interstitial infiltrate in 90.48% followed by alveolar infiltrates in 8.84% cases. Pleural effusion was detected in 13 patients (8.84%). [ncbi.nlm.nih.gov]

    Another study by Puljiz et al. [40] found that the commonest chest x-ray abnormality was interstitial infiltrate in 90.48% followed by alveolar infiltrates in 8.84% cases. Pleural effusion was detected in 13 patients (8.84%). [lungindia.com]

  • Mediastinal Mass

    Exploratory thoracotomy revealed a large mediastinal mass that was removed together with the right middle and lower lobes of the lung. The mass arose from the lung with an endobronchial element. [ncbi.nlm.nih.gov]

Microbiology

  • Mycoplasma Hominis

    Mycoplasma hominis IgG positive control IgG 0.1 ml CI 2202-0101 G antibodies against Mycoplasma pneumoniae IgG positive control IgG 0.1 ml CI 2202-0101 M antibodies against Mycoplasma pneumoniae IgM positive control IgM 0.1 ml [euroimmun.com]

    Crossref, Google Scholar 13 Pereyre S, Gonzalez P, de Barbeyrac B et al. : Mutations in 23S rRNA account for intrinsic resistance to macrolides in Mycoplasma hominis and Mycoplasma fermentans and for acquired resistance to macrolides in M. hominis. [futuremedicine.com]

    The ones you may have to worry about are: Mycoplasma pneumoniae Mycoplasma genitalium Mycoplasma hominis Ureaplasma urealyticum Ureaplasma parvum Mycoplasma pneumoniae This type causes lung infections. [webmd.com]

  • Complement Fixing Antibody

    Method: Immunoenzymatic method for the semiquantitative determination of complement-fixing antibodies in human serum, using a disposable device applied on the Chorus and Chorus TRIO instruments. [diesse.it]

    Abstract The sera of 30 patients with complement-fixing antibodies to Mycoplasma pneumoniae (titres larger than or equal to 32) were treated with staphylococcal protein A. This procedure effectively removed 90 to 95% of the IgG antibodies. [ncbi.nlm.nih.gov]

Pleura

  • Pleural Effusion

    The possibility of Mycoplasma pneumonia should not be dismissed merely because of the severity of the illness or the presence of pleural effusions. [ncbi.nlm.nih.gov]

    Pleural effusions were seen in seven patients (17%), and all effusions occurred on the left side except for bilateral effusions in one patient. [pubs.rsna.org]

Treatment

From our results, we consider that roxithromycin is useful in the treatment of mycoplasma pneumonia. [ncbi.nlm.nih.gov]

The early treatment group had significantly fewer extrapulmonary complications vs the late treatment group. [pulmonologyadvisor.com]

2 probably because the efficacy of macrolides in the treatment of M. pneumoniae remains unclear and treatment recommendations, even in major textbooks, are variable. 4, 10 The available evidence is also conflicting. [doi.org]

Prognosis

Azithromycin therapy timing is not associated with Mycoplasma pneumoniae pneumonia clinical prognosis in children in high macrolide-resistant M pneumoniae prevalence settings, according to results published in PLoS One. [pulmonologyadvisor.com]

Hypercytokinemia is a useful marker of disease activity and prognosis. Combined treatment with methylprednisolone and erythromycin was successful and led to a favorable outcome. Physicians should be aware of HPS as a complication in Mp infection. [ncbi.nlm.nih.gov]

Links: clinical features investigations treatment of mycoplasma pneumonia complications prognosis [gpnotebook.co.uk]

Treatment and prognosis Most patients recover well although a small proportion of patients may develop bronchiectasis in the affected region or Swyer James syndrome. Promoted articles (advertising) [radiopaedia.org]

Etiology

When young children with Down syndrome develop pneumonia, physicians should consider Mycoplasma pneumoniae as the possible etiologic agent. [ncbi.nlm.nih.gov]

Bacterial etiology of acute myringitis in children less than two years of age. Pediatr Infect Dis J. 2001 Jun. 20(6):607-11. [Medline]. Roberts DB. The etiology of bullous myringitis and the role of mycoplasmas in ear disease: a review. [emedicine.com]

Epidemiology

Keywords: Atypical bacterial pneumonia, CAP, epidemiology, Mycoplasma pneumoniae. [eurekaselect.com]

Epidemiology and clinical characteristics of community-acquired pneumonia in hospitalized childrenExternal. Pediatrics. 2004;113:701–7. [cdc.gov]

Epidemiology • One of the common causes of acquired pneumonias in • • • • • healthy patients. < 40 years. Common in all age groups Rare in <5 yeas old children Highest rates are seen in 5-20 year age group. The incubation period is 1-3 weeks. [pt.slideshare.net]

Although there is no pathognomonic clinical or radiographic presentation, careful consideration of epidemiologic, clinical, laboratory, and radiographic data are usually sufficient to suggest the diagnosis in most patients. [ncbi.nlm.nih.gov]

Objectives After completing this article, readers should be able to: Understand the microbiology and epidemiology of Mycoplasma pneumoniae infection. [pedsinreview.aappublications.org]

Pathophysiology

These increased immune responses may be associated with the pathophysiological mechanisms by which the Mycoplasma pneumoniae contribute to the development of wheeze during acute mycoplasma pneumonia. (c) 2009 Wiley-Liss, Inc. [ncbi.nlm.nih.gov]

Pathophysiology[edit] Mycoplasma pneumoniae is spread through respiratory droplet transmission. Once attached to the mucosa of a host organism, M. pneumoniae extracts nutrients, grows, and reproduces by binary fission. [en.wikipedia.org]

Pathophysiology • The Mycoplasma organism produces a protein that allows • • • • attachment to a receptor on the respiratory epithelium. [pt.slideshare.net]

Prevention

Doctors generally do not prescribe antibiotics to help prevent someone else from getting sick (for example, a close contact of an infected person). [cdc.gov]

It is not known whether early therapy prevents dreaded complications. Copyright 2010. Published by Elsevier Inc. [ncbi.nlm.nih.gov]

Waites, M.D., professor of pathology and director of the UAB Diagnostic Mycoplasma Laboratory, will lead one of those infectious disease sentinels with the help of a one-year, $512,000 contract from the United States Centers for Disease Control and Prevention [uab.edu]

Prevention Exclusion from childcare, preschool, school or work is not necessary no vaccine is currently available cover a cough or sneeze with a tissue or your arm, not with your hand. [sahealth.sa.gov.au]

[…] and Prevention, and the Research Ethics Committee of the Beijing Children’s Hospital. [aricjournal.biomedcentral.com]

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