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Mycoplasma pneumonia

Definition

Mycoplasma pneumonia is an infection of the lungs from the bacteria Mycoplasma pneumoniae (M. pneumoniae).

See also:

• Atypical pneumonia
• Viral pneumonia

Causes, incidence, and risk factors

Mycoplasma pneumonia is a type of atypical pneumonia. It is caused by the bacteria M. pneumoniae. This type of pneumonia usually affects people younger than 40. Various studies suggest that it makes up 15 - 50% of all pneumonia cases in adults and even more in school-aged children.

People at highest risk for mycoplasma pneumonia include those living or working in crowded areas such as schools and homeless shelters, although many people who contract mycoplasma pneumonia have no identifiable risk factor.

Symptoms

The symptoms are generally mild and appear over a period of 1 to 3 weeks. They may become more severe in some people.

Common symptoms include the following:

• Chest pain
• Chills
• Cough, usually dry and not bloody
• Excessive sweating
• Fever (may be high)
• Headache
• Sore throat

Less common symptoms include:

• Ear pain
• Eye pain or soreness
• Muscle aches and joint stiffness
• Neck lump
• Rapid breathing
• Skin lesions or rash

Signs and tests

Persons with suspected pneumonia should have a complete medical evaluation, including a thorough physical exam and a chest x-ray -- especially because the physical exam may not always be able to tell pneumonia apart from acute bronchitis or other respiratory infections.

Depending on the severity of illness, other tests may be done, including:

• Complete blood count (CBC)
• Blood cultures
• Blood tests for antibodies to mycoplasma
• Bronchoscopy
• CT scan of the chest
• Open lung biopsy (only done in very serious illnesses when the diagnosis cannot be made from other sources)
• Sputum culture to check for mycoplasma bacteria

A urine test or a throat swab may also be done.

Treatment

Antibiotics that work against Mycoplasma include macrolides, quinolones, and tetracyclines. You can take these steps at home:

• Control your fever with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children.
• Do not take cough medicines without first talking to your doctor. 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. Have someone else do household chores.

Support Groups

Expectations (prognosis)

Most people recover completely even without antibiotics, although antibiotics may speed recovery. In untreated adults, cough and weakness can persist for up to a month.

Complications

• Ear infections
• Hemolytic anemia
• Severe pneumonia
• Skin rashes

Calling your health care provider

Call for an appointment with your health care provider if you develop a fever, cough, or shortness of breath. While there are numerous causes for these symptoms, you will need to be checked for pneumonia.

Also, call if you have been diagnosed with this type of pneumonia and your symptoms become worse.

Prevention

There is no known way to prevent atypical pneumonia. However, avoiding people who have the infection can help reduce your risk.

Infants, and persons in poor health, especially those with weakened immune systems due to HIV, organ transplants, or other conditions should avoid contact with people who have mycoplasma pneumonia.

References

Baum SG. Mycoplasma pneumoniae and atypical pneumonia. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 184.

Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44:S27-S72.