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Mycoplasma Pneumonia Symptoms In Adults

What Complications Might You Expect From The Disease Or Treatment Of The Disease

Mycoplasma Pneumonia: Causes, Symptoms, and Diagnosis

Complications from pneumonia include the evolution of pleural effusions, or the development of respiratory failure, a rare but life-threatening problem. The formation of lung abscess has also been described.

In patients with dermatologic manifestations of infection, vigilance must be maintained regarding the development of erythema multiforme major. Such patients may need aggressive fluid and electrolyte support, and, in serious cases, airway assistance with mechanical ventilation is required, allowing the ulcerative process in the upper airway to heal.

How Does Mycoplasma Cause Infection

Infection is spread by contact with droplets released from the upper and lower respiratory tracts of infected persons. The incubation period varies from 13 weeks. M. pneumoniae is a common cause of community-acquired pneumonia worldwide. Immunity after mycoplasma infection is short lived and it is possible to developrecurrent infections.

If You Are Able To Confirm That The Patient Has A Mycoplasma Pneumoniae Infection What Treatment Should Be Initiated

Appropriate antibiotic treatment of mycoplasma infection shortens the course of the illness and speeds alleviation of symptoms. Macrolide group antibiotics are the medications of choice, but tetracyclines and fluoroquinolones are also effective.

Mycoplasma does not have a cell wall, and is, therefore, intrinsically resistant to cell wall active agents such as beta lactam antibiotics. Sulfonamides, trimethoprin, and rifampin are also ineffective. Lincosamindes appear to have low minimal inhibitory concentrations in vitro, but are not clinically effective. Oxazolidinones do not show promise in vitro and should be avoided. Ketolides show promise against M. pneumoniae in vitro, but clinical data in children are lacking, and the potential for liver toxicity has led to caution in using this antibiotic.

High dose glucocorticoids have been reported to be useful as adjunctive therapy in patients with mycoplasma encephalitis. Plasmapheresis and intravenous immunoglobulin therapy has also been used in such settings, but it is unclear whether these strategies offer substantial clinical benefit.

Macrolides and macrolide resistance

Susceptibility testing is not routinely available and is only rarely performed, but the emergence of macrolide-resistant M. pneumoniae raises concerns about the usual empiric coverage choices in some parts of the world. Naturally occurring tetracycline- or fluoroquinolone-resistant strains have not yet been described.


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What Is The Evidence

Gardiner, SJ, Gavranich, JB, Chang, AB. Antibiotics for community-acquired lower respiratory tract infections secondary to in children. Cochrane Database Syst Rev.. vol. 1. 2015. pp. CD004875

Zheng, X, Lee, S, Selvarangan, R. Macrolide-resistant , United States. Emerg Infect Dis. vol. 21. 2015. pp. 1470-1472.

Waites, KB, Talkington, DF. and its role as a human pathogen. Clin Micro Rev. vol. 17. 2004. pp. 697-728.

Atkinson, TP, Waites, KB. infections in childhood. Pediatr Infect Dis J. vol. 33. 2014. pp. 92-94.

Atkinson, TP, Balish, MF, Waites, KB. Epidemiology, clinical manifestations, pathogenesis and laboratory detection of infections. FEMS Microbiol Rev. vol. 32. 2008. pp. 956-973.

Al-Zaidy, SA, MacGregor, D, Mahant, S. Neurological complications of PCR-proven infections in children: prodromal illness duration may reflect pathogenetic mechanism.. Clin Infect Dis. vol. 61. 2015. pp. 1092-1098.

Can Pneumonia Be Prevented

Walking Pneumonia Symptoms in Adults

Check with your healthcare provider about getting immunizations. The flu is a common cause of pneumonia. Because of that, getting a flu shot every year can help prevent both the flu and pneumonia.

There is also a pneumococcal vaccine. It will protect you from a common form of bacterial pneumonia. Children younger than age 5 and adults ages 65 and older should get this shot.

The pneumococcal shot is also recommended for all children and adults who are at increased risk of pneumococcal disease due to other health conditions.

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How Is Mycoplasma Spread

Mycoplasma is spread through contact with droplets from the nose and throat of infected people especially when they cough and sneeze. Transmission is thought to require prolonged close contact with an infected person. Spread in families, schools and institutions occurs slowly. The contagious period is probably fewer than 10 days and occasionally longer.

How Is Walking Pneumonia Different From Regular Pneumonia

Walking pneumonia differs from typical pneumonia in several ways, including:

  • Walking pneumonia is a milder form of pneumonia.
  • Walking pneumonia usually does not require bed rest or hospitalization.
  • Walking pneumonia is usually caused by Mycoplasma pneumoniae. Typical pneumonia is most commonly caused by _Streptococcus _pneumonia or influenza virus or rhinovirus.

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Skin And Mucosal Manifestations

Among patients with M. pneumoniae infection, 25% may have dermatological manifestations, making these one of the common complications of this infection. There is a well-known association between Mycoplasma and Stevens-Johnson syndrome, erythema multiforme and toxic epidermal necrolysis. M. pneumoniae is the most common infectious agent associated with Stevens-Johnson syndrome. The Stevens-Johnson syndrome is an acute, self-limited disease characterized by severe inflammation and necrosis of two or more mucous membranes with systemic symptoms such as fever and malaise. This is in contrast to erythema multiforme , which is a mild cutaneous illness characterized by symmetrically distributed, fixed, discrete, round, red papules, some of which evolve into target lesions, but without mucosal involvement and systemic toxicity.

Diagnosis Of M Pneumoniae Infection

Mycoplasma pneumoniae (Walking Pneumonia)

Clinical suspicion of M. pneumoniae infection arises in a patient with a respiratory illness and any type of rash, but especially an erythema multiforme-like eruption.

The most rapid diagnostic test is M. pneumoniaepolymerase chain reaction of a throat swab, which has a sensitivity and specificity of 78100%.

Mycoplasma serology detects IgM and IgGantibodies after a 710 days and 3 weeks respectively. The sensitivity and specificity of serologic testing is lower than PCR but can be increased by arranging a second test in the convalescent phase of the illness. A positive test is confirmed if a single titre is > 1:32 or a fourfold increase in an IgG or IgM titre from baseline is found on repeat testing. IgM titres remain raised for weeks, and IgG remains raised for many months after mycoplasma infection.

Chest x-ray findings in M. pneumoniae infection are non-specific. Most commonly, there is patchy consolidation in one or both lungs. Small pleural effusions may be seen in up to 20% of cases.

The results of routine blood testing are also non-specific. The total white cell count, and differential counts may be within normal limits. Inflammatory marker testing may reveal normal, or elevated CRP and ESR levels. There may be mild, non-specific abnormalities in the liver function test results.

Full blood count testing may reveal:

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When Is Mycoplasma Test Ordered

Mycoplasma pneumoniae testing may be ordered when someone has severe respiratory symptoms that are not due to a typical bacterial infection, such as pneumococcal pneumonia. Some of these symptoms may include:

  • Nonproductive cough that may persist for several weeks
  • Fever
  • Sore throat
  • Headaches and muscle aches

Testing may be done when an infection spreads to the lower respiratory tract, causing walking pneumonia, and/or spreads to other parts of the body and causes complications such as rash, arthritis, encephalitis, inflammation of the heart muscle or the lining that surrounds the heart or hemolytic anemia, and when a person is not responding to standard treatments. It may also be ordered to help track and control the spread of Mycoplasma pneumoniae infections during an outbreak.

Testing for other species of mycoplasma may be performed, in addition to Mycoplasma pneumoniae testing, when very young infants and those with compromised immune systems have lung and/or systemic infections or complications that could be due to a mycoplasma infection.

In general, IgM and IgG testing are performed when a health practitioner suspects that a person has an active Mycoplasma pneumoniae infection, and another IgG test may be performed 2-4 weeks later to document a rise in antibody levels in response to an infection. A Mycoplasma pneumoniae culture and a DNA test may also be ordered when an active infection is suspected.

How Is Mycoplasma Test Used

Mycoplasma testing is primarily used to help determine if Mycoplasma pneumoniae is the cause of a respiratory tract infection. It may also be used to help diagnose a systemic infection that is thought to be due to mycoplasma.

Blood tests for antibody to Mycoplasma pneumoniae

Two types of antibodies produced in response to an Mycoplasma pneumoniae infection may be measured in the blood, IgM and IgG.

  • IgM antibodies are the first to be produced by the body in response to infection. Levels of IgM rise for a short time period and then decline, often remaining detectable in the blood for several months.
  • IgG antibody production follows IgM production, rising over time, and then stabilizing. Once a person has had a mycoplasma infection, they will typically have some measurable amount of mycoplasma IgG antibody in their blood for the rest of their life.

In order to diagnose an active Mycoplasma pneumoniae infection, a health practitioner may order both Mycoplasma pneumoniae IgM and IgG antibody tests as acute samples and then collect another Mycoplasma pneumoniae IgG test two to four weeks later as a convalescent sample. This combination of tests is ordered so that the change in the amount of IgG can be evaluated and because some people, especially infants and those with compromised immune systems, may not produce expected amounts of IgG or IgM.

Direct detection

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Positive Pcr In A Culture

  • Persistence of the organisms after infection.

  • Asymptomatic carriage, perhaps in a intracellular compartment that does not yield culturable organisms.

  • Negative PCR results in culture or serologically proven infections increase the possibility of inhibitors or other technical problems with the assay and its gene target. Reznikov et al. showed that PCR inhibition was more likely to occur with nasopharyngeal aspirates than with throat swabs and recommended the latter specimen for diagnostic purposes. On the other hand, Dorigo-Zetsma et al. performed a comprehensive examination with 18 patients with M. pneumopniae respiratory tract infection and they found that sputum was the specimen that was most likely to be PCR positive . There are commercial reagents for nucleic acid purification that are effective in removing most inhibitors of amplification in PCR assays.

    Combined use of PCR with IgM serology may be a useful approach for diagnosis of M. pneumoniae respiratory infection in children, but potentially less useful in adults who may not mount an IgM response. A possible alternative, especially in older adults may be a combination of PCR with IgA serology. Combining these two diagnostic modalities may help in distinguishing colonization from active disease.

    How Do These Pathogens/genes/exposures Cause The Disease

    Mycoplasma infections: causes, symptoms, diagnosis, and treatment ...

    Infection leads to ulceration and destruction of the ciliated epithelium of the respiratory tract with infiltration of macrophages, neutrophils, lymphocytes, and plasma cells. Diffuse alveolar damage may ensue in the most severe cases. Pleural effusions, bronchiectasis, abscess formation, and pulmonary fibrosis are rare but serious sequelae.

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    Walking Pneumonia Symptoms In Adults

    Walking pneumonia is a mild type of pneumonia, which does not require bed rest or high dosage of medicines for its cure. This condition is not very easy to diagnose, because its symptoms mimic those of common cold. Let’s find out more about walking pneumonia symptoms in adults.

    Walking pneumonia is a mild type of pneumonia, which does not require bed rest or high dosage of medicines for its cure. This condition is not very easy to diagnose, because its symptoms mimic those of common cold. Lets find out more about walking pneumonia symptoms in adults.

    Walking pneumonia may sound alarming, however, it is not something to be worried about! People are aware of pneumonia, but very few people are acquainted with the term walking pneumonia. The term walking pneumonia is used to describe a mild version of pneumonia, caused by the organism mycoplasma pneumoniae. Recently, another causative organism chlamydia pneumoniae has been identified that conduces to similar infections. Both Mycoplasma and Chlamydia are observed to affect young adults. Nevertheless, even viruses can cause walking pneumonia.

    But the question propping up next is, how do we identify walking pneumonia? Walking pneumonia symptoms bear semblance to influenza symptoms, which makes their identification cumbersome. However, observing the signs and symptoms of walking pneumonia in adults may assist in the identification of this mild strain of pneumonia.

    Symptoms of Walking Pneumonia in Adults

    Nucleic Acid Amplification Test

    PCR tests as single or multiplex assays are the diagnostic method of choice for acute MP infection . MP PCR using respiratory tract samples is fast and sensitive. However, it lacks specificity because it cannot distinguish between true patients and asymptomatic carriers . Thus, positive results should be interpreted cautiously in context with clinical findings. Positive PCR results in the pleural fluid or tissue can establish a definite diagnosis . Given the recent evidence that pleural biopsies improved microbiological yield in pleural infection , pleural tissue, only when available, may be a good sample for detection of MP, particularly through PCR tests.

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    How Is Walking Pneumonia Diagnosed

    Your doctor will ask you about your symptoms, how long youve had them and if any other family members or people you regularly interact with are also ill with similar symptoms. He or she will listen to your lungs with a stethoscope to check for abnormal breath sounds. Your doctor may order chest X-rays to see if there is an infection in your lungs. Your blood or mucus might be tested to determine if your pneumonia is caused by Mycoplasma pneumoniae, another bacteria, virus or fungus.

    What Is Mycoplasma Pneumonia

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    Pneumonia is an infection of the lungs. People of all ages can get this kind of pneumonia, but it usually affects people younger than 40, most often those who are 5 to 20 years old. Some people may not be sick enough to stay in bed or go to the health care provider, and they may never even know that they had pneumonia. Its often called walking pneumonia. These infections occur throughout the year but are seen slightly more often during winter.

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    How Is Mycoplasma Pneumonia Treated

    Oral antibiotics are given, usually for 5 to 14 days, to treat the infection. Improvement usually begins within 1 or 2 days of starting antibiotics, but the cough may last for weeks. Nasal sprays and oral decongestants are often used for nasal symptoms. Rest, a well balanced diet, and drinking enough fluids are important for recovery.

    What Causes This Disease And How Frequent Is It

    Surveillance in the United States indicates that mycoplasma is responsible for 15-20% of all community-acquired pneumonia . In Scandinavia, M. pneumoniae was detected in 30% of all pediatric CAP, and in over 50% among children older than 5 years. The incidence is greatest among school-aged children and declines after adolescence.

    Serologic studies have shown that disease transmission occurs as cyclical epidemics every 3-5 years. The long incubation period, relatively low transmission rate, and persistence of the organism in the respiratory tract for variable periods following infection may explain why epidemics last for long period of time.

    The incubation period may be as long as 3 weeks.

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    Where Can You Acquire Pneumonia

    You can get pneumonia from a variety of different places, which include:

    • Community-acquired pneumonia . This is pneumonia that you get outside of a hospital or healthcare facility. Its estimated that CAP is the third most common cause of hospitalization in people ages 65 years and older.
    • Healthcare-associated pneumonia. This is pneumonia that you acquire while in a healthcare facility. Older adults who are hospitalized or in a long-term care facility may be at an increased risk for this type of pneumonia.
    • Aspiration pneumonia. This happens when you inhale things like food, saliva, or vomit into your lungs. Older individuals with swallowing disorders can be at higher risk for developing this type of pneumonia.

    Ureaplasma Urealyticum And Ureaplasma Parvum

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    Most healthy women have these bacteria in their cervix or vagina, and a smaller number of men also have them in their urethra. Normally, they don’t cause any problems.

    Ureaplasma can spread during sex. If you’re pregnant and you’re infected, you can pass the bacteria to your baby in the womb or during childbirth.

    Some symptoms women can get are:

    • It hurts when you pee
    • Belly pain
    • Pain, odor, or discharge from the vagina
    • Swelling at the opening of the urethra
    • Discharge from the urethra

    Men who are infected can get inflammation of the urethra, called urethritis.

    During pregnancy, the bacteria can lead to infections in both the mother and the baby. Problems in newborn babies can include:

    • Low birth weight
    • Bacteria in the blood, called septicemia

    To diagnose a ureaplasma infection, your doctor can take a sample of fluid from:

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    What Are The Signs And Symptoms Of Mycoplasma Infections

    Typical symptoms can develop and persist over weeks to months and include flulike manifestations.

    Symptoms may include the following:

    • Generalized aches and pains

    • Earache

    • General malaise

    In very young children, upper respiratory tract manifestations may predominate, whereas in older children and adults, lower respiratory tract symptoms are more likely.

    What Is Mycoplasma Pneumoniae

    Mycoplasma pneumoniae is a type of atypical bacteria that commonly causes mild infections of the respiratory system, with an estimated 2 million cases in the U.S. each year. Experts estimate that Mycoplasma pneumoniae infections account for between 1 and 10 in every 50 cases of community-acquired pneumonia. Mycoplasma pneumoniae is often called community-acquired atypical pneumonia because it does not respond to sulfonamides or penicillin . Mycoplasma pneumoniae pneumonia is sometimes referred to as walking pneumonia since symptoms tend to be milder than pneumonia caused by other germs. Mycoplasma pneumoniae infections can occur at any time of the year, but outbreaks are more prevalent in the late summer and early autumn.

    Pneumonia is inflammation or swollen lung tissue due to infection with a germ. The most common type of illness caused by Mycoplasma pneumoniae bacteria, especially in children, is tracheobronchitis, commonly called a chest cold. Symptoms often include being tired and having a sore throat, fever, and cough. However, sometimes Mycoplasma pneumoniae can cause a more serious pneumonia, which may require care in a hospital. Mycoplasma pneumoniae pneumonia is usually mild and responds well to treatment with antibiotics. Having a mycoplasma infection does not confer immunity. A person can become re-infected.

    Key facts

  • Most Mycoplasma pneumoniae infections are mild and get better on their own without treatment, but serious complications can occur.
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