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Mycoplasma Pneumonia

An older woman coughing

What is mycoplasma pneumonia?

Mycoplasma pneumonia is usually a very mild type of pneumonia caused by infection with the bacterium Mycoplasma pneumoniae.

The condition is often called “walking pneumonia” because of its usually benign (not harmful) nature and low mortality. However, mortality in some subpopulations (such as the elderly) may be as high as 30%.

What causes mycoplasma pneumonia?

Mycoplasma pneumonia is caused by the bacteria Mycoplasma pneumoniae. M. pneumoniae is considered an “atypical” bacteria because in most people it causes few if any, symptoms and infected people rarely seek medical attention. It is widespread worldwide and studies have shown an association of M. pneumoniae infections with climate change with a 17% rise in mycoplasma pneumonia cases with every 1°C rise in temperature.

Mycoplasma pneumonia is one of the most common types of community-acquired pneumonia (pneumonia that is acquired in the community setting rather than in a hospital), especially during epidemics.

People more at risk of mycoplasma pneumonia include those with asthma or chronic obstructive pulmonary disease (COPD). Outbreaks are also common among schools, colleges, and nursing homes.

Tests are unable to differentiate active infection from a carrier state so experts are unsure if the bacteria reside and persist in humans.

What are the symptoms of mycoplasma pneumonia?

Symptoms of mycoplasma pneumonia are nonspecific and may include:

  • Cough
  • Fever
  • Gastrointestinal symptoms (such as abdominal pain, diarrhea, nausea, vomiting)
  • Muscle pain
  • Tiredness

Vital signs (such as temperature, pulse rate, respiration rate, and blood pressure) may be normal in many people. Sometimes other symptoms such as a skin rash, cardiac arrhythmias, or blood clots can occur in association with M. pneumoniae infection. Neurological symptoms (such as drowsiness, confusion, personality changes) may occur in up to 10% of people, more commonly children.

In children, the most common type of illness caused by M. pneumoniae is tracheobronchitis (a chest cold). Symptoms include:

  • Cough
  • Fever
  • Sore throat
  • Tiredness

Pneumonia may also develop in children which may require hospital care.

How is mycoplasma pneumonia diagnosed?

Mycoplasma pneumonia is difficult to diagnose because it causes few symptoms and symptoms that do occur are nonspecific and similar to other upper respiratory tract infections. X-ray findings are also generally nonspecific for mycoplasma pneumonia.

If you think you may have pneumonia, see your doctor. Your doctor will ask you about your symptoms and perform a physical examination. They may also order an X-ray or other tests. There is no specific diagnostic test for mycoplasma pneumonia and mycoplasmas are not visible by gram staining because of their lack of a cell wall.

How is mycoplasma pneumonia treated?

Although some mycoplasma pneumonia infections resolve by themselves within 7 to 10 days, treatment with antibiotics is often necessary.

Treatments may include:

  • Macrolides, such as azithromycin
  • Ketolides, such as telithromycin
  • Streptogramins, such as Synercid
  • Fluoroquinolones
  • Tetracyclines
  • Other treatments, such as steroids, for life-threatening manifestations.