Mycoplasma pneumonia

Aka: Mycoplasma pneumonia, Mycoplasma pneumoniae, Walking Pneumonia

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II. Pathophysiology

  1. Interstitial infection of lung parenchyma
  2. Organism lacks a cell wall
  3. Results in respiratory infections
    1. Atypical Pneumonia (3-10% of infected patients)
    2. Acute Tracheobronchitis
    3. Upper Respiratory Infection

III. Epidemiology

  1. Affects children (over age 3 years) and young adults
    1. May also be seen in the elderly

IV. Symptoms

  1. Slow, gradual onset of prodromal symptoms
    1. Malaise
    2. Headache
    3. Fever
      1. Usually present longer than 3 days at presentation
  2. Cough
    1. Constant, harsh, dry, hacking non-productive cough
  3. Upper respiratory symptoms (50%)
    1. Pharyngitis
    2. Ear Pain
  4. Accompanying symptoms
    1. Rash
    2. Arthralgias

V. Signs

  1. Minimal signs
  2. Chest auscultation
    1. Scattered rhonchi
    2. Localized rales
  3. Serous Otitis Media
  4. Wheezing may be present
    1. Usually absent in other Bacterial Pneumonia
    2. Wheezing otherwise more common with Viral Pneumonia

VI. Differential Diagnosis

  1. Viral Pneumonia (e.g. Adenovirus)
  2. Bacterial Pneumonia associated with other atypicals
    1. Chlamydia pneumoniae
    2. Legionella pneumonia

VII. Radiology: Chest XRay

  1. Fine patchy interstitial or perihilar infiltrates
  2. Lower lobe more commonly affected

VIII. Labs

  1. Complete Blood Count
    1. WBC Count mildly elevated (10,000 to 15,000)
  2. Cold Agglutinins
    1. Nonspecific
    2. Not sensitive (false negative in 33% of cases)
  3. Mycoplasma complement fixation titers
    1. Obtain acute and convalescent titers

IX. Management: Antibiotic for 10 to 14 days

  1. Erythromycin
  2. Clarithromycin (Biaxin)
  3. Azithromycin (Zithromax)
  4. Doxycycline
    1. Avoid in age <8 years or pregnancy
    2. Dosing: 100 mg PO daily for 10 to 14 days
    3. Alternative dosing
      1. Dose twice daily for 1 day, once daily for 13 days
      2. Reduces gastrointestinal side effects

X. Complications

  1. Complications are uncommon
  2. Mortality rate: 1.4%
  3. Pulmonary
    1. Pleural Effusion
    2. Empyema
    3. Respiratory distress syndrome
  4. Dermatologic
    1. Erythema Multiforme
    2. Erythema Nodosum
    3. Urticaria
  5. Neurologic
    1. Aseptic Meningitis
    2. Encephalitis
    3. Guillain-Barre Syndrome
    4. Transverse myelitis
  6. Cardiovascular
    1. Myocarditis
    2. Pancreatitis
    3. Pericarditis
  7. Miscellaneous
    1. Hemolytic Anemia
    2. Polyarthritis

XI. References

  1. Gilbert (2001) Sanford Antimicrobial, p. 25
  2. File (1998) Infect Dis Clin North Am 12(3):569-92 [PubMed]
  3. O&#39;Handley (1997) J Am Board Fam Pract 10(6):425-9 [PubMed]
  4. Plouffe (2000) Clin Infect Dis 31:S35-9 [PubMed]
  5. Tan (1999) Can Respir J 6:15A-9A [PubMed]

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Ontology: Mycoplasma pneumonia (C0032302)

Definition (MSH) Interstitial pneumonia caused by extensive infection of the lungs (LUNG) and BRONCHI, particularly the lower lobes of the lungs, by MYCOPLASMA PNEUMONIAE in humans. In SHEEP, it is caused by MYCOPLASMA OVIPNEUMONIAE. In CATTLE, it may be caused by MYCOPLASMA DISPAR.
Definition (CSP) interstitial pneumonia caused by extensive infection of the lungs and bronchi, particularly the lower lobes of the lungs, by Mycoplasma species.
Concepts Disease or Syndrome (T047)
MSH D011019
ICD9 483.0
ICD10 J15.7
SnomedCT 46970008, 155554001, 195894001, 195895000
English Mycoplasma Pneumonia, Mycoplasma Pneumonias, Pneumonia, Mycoplasma, Pneumonias, Mycoplasma, PPLO, mycoplasmal pneumonia, Mycoplasma pneumonia, Eatons agent pneumonia, M pneumoniae pneumonia, Atypical Pneumonia, Primary, Atypical Pneumonias, Primary, MYCOPLASMA PNEUMONIA, Pneumonia, Primary Atypical, Pneumonias, Primary Atypical, Primary Atypical Pneumonia, Primary Atypical Pneumonias, Eaton's agent pneumonia, Eaton agent pneumonia, cold agglutinin positive pneumonia, Mycoplasma pneumonia (diagnosis), primary atypical Mycoplasma pneumoniae, Pneumonia due to mycoplasma pneumoniae, Pneumonia mycoplasmal, Pneu mycplsm pneumoniae, Pneumonia, Mycoplasma [Disease/Finding], mycoplasmas pneumonia, pplo, pneumonia mycoplasma, primary atypical pneumonia, mycoplasma pneumonia, Primary atypical pneumonia, Pneumonia primary atypical, Mycoplasmal pneumonia (disorder), Endemic pneumonia, PAP due to Mycoplasma pneumoniae, Primary atypical pneumonia due to Mycoplasma pneumoniae, Mycoplasma pneumoniae pneumonia, Mycoplasmal pneumonia, Pneumonia due to PPLO, Infection by PPLO, Pneumonia due to Mycoplasma pneumoniae, Pneumonia due to Mycoplasma pneumoniae (disorder), Mycoplasma; pneumonia, pneumonia; Eaton's agent, pneumonia; Mycoplasma, Eaton's agent; pneumonia, EP, Mycoplasma pneumonia (disorder), Pneumonia due to Eaton's agent
Italian Polmonite da Mycoplasma, Polmonite da Mycoplasma pneumoniae, Polmonite da Micoplasma, Polmonite primaria atipica, Polmonite atipica primaria, Polmonite da Mycoplasma Pneumoniae
Dutch Mycoplasma pneumoniae-pneumonie, pneumonie door Mycoplasma pneumoniae, pneumonie primair atypisch, primaire atypische pneumonie, Eaton's agent; pneumonie, Mycoplasma; pneumonie, pneumonie; Eaton's agent, pneumonie; Mycoplasma, Pneumonie door Mycoplasma pneumoniae, Mycoplasma-pneumonie, Mycoplasmapneumonie, Pneumonie, mycoplasma-, Pneumonie, primaire atypische
French Pneumonie à mycoplasma pneumoniae, Pneumonie à Mycoplasma pneumoniae, Pneumopathie à mycoplasmes, Pneumopathie à mycoplasme, Pneumonie à mycoplasmes, Pneumopathie à Mycoplasma, Pneumonie atypique, Pneumonie à Mycoplasme, Pneumonie primitive atypique, Pneumonie à Mycoplasma, Pneumonie à mycoplasme
German Pneumonie durch Mycoplasma pneumoniae, Mycoplasma pneumoniae-Pneumonie, Pneumonie primaer atypisch, primaere atypische Pneumonie, Pneumonie durch Mykoplasmen, Mykoplasmapneumonie, Pneumonie, Mycoplasma-, Pneumonie, primäre, atypische
Portuguese Pneumonia por Mycoplasma pneumoniae, Pneumonia micoplásmica, Pneumonia primária atípica, Pneumonia atípica primária, Pneumonia a micoplasma, Pneumonia Atípica Primária, Pneumonia por Mycoplasma
Spanish Neumonía por Mycoplasma pneumoniae, neumonía por agente Eaton, neumonía por Mycoplasma, Neumonía atípica primaria, neumonía atípica primaria por Mycoplasma pneumoniae, neumonía endémica, neumonía micoplasmática, Neumonía por mycoplasma, neumonía por Mycoplasma (trastorno), neumonía por Mycoplasma pneumoniae (trastorno), neumonía por Mycoplasma pneumoniae, Neumonía por Mycoplasma, Neumonía Primaria Atípica
Swedish Lunginflammation, mykoplasma
Japanese ﾏｲｺﾌﾟﾗｽﾞﾏｾｲﾊｲｴﾝ, 肺炎-マイコプラスマ, ミコプラズマ肺炎, マイコプラズマ肺炎, マイコプラズマ性肺炎, 肺炎-ミコプラズマ, 肺炎-寒冷凝集反応陽性, マイコプラスマ肺炎, 肺炎マイコプラズマ性肺炎, ﾊｲｴﾝﾏｲｺﾌﾟﾗｽﾞﾏｾｲﾊｲｴﾝ, 肺炎-マイコプラズマ性, 寒冷凝集反応陽性肺炎, ｹﾞﾝﾊﾟﾂｾｲｲｹｲﾊｲｴﾝ, 原発性異型肺炎
Finnish Mykoplasmakeuhkokuume
Russian PNEVMONIIA MIKOPLAZMENNAIA, MIKOPLAZMENNAIA PNEVMONIIA, МИКОПЛАЗМЕННАЯ ПНЕВМОНИЯ, ПНЕВМОНИЯ МИКОПЛАЗМЕННАЯ
Czech Mykoplazmová pneumonie, Pneumonie způsobená Mycoplasma pneumonie, Pneumonie způsobená mykoplazmaty, pneumonie mykoplasmová, Primární atypická pneumonie, mykoplazmová pneumonie, mycoplasma pneumoniae, pneumonie mykoplazmová
Korean 미코플라스마 폐렴균에 의한 폐렴
Polish Zapalenie płuc mykoplazmatyczne
Croatian PNEUMONIJA, MIKOPLAZMA
Hungarian mycoplasma okozta pneumonia, Mycoplasma pneumoniae pneumonia, Mycoplasma által okozott pneumonia, Mycoplasma pneumoniae okozta pneumonia, Primaer atypusos pneumonia, primaer atypusos pneumonia
Norwegian Pneumoni som skyldes Mycoplasma pneumoniae, Mykoplasmalungebetennelse, Kald lungebetennelse, Mykoplasmapneumoni
Derived from the NIH UMLS (Unified Medical Language System)

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