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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.

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Section 3. Summaries of Infectious Diseases

Mycoplasma pneumoniae Infections

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS: The most common clinical syndromes are acute bronchitis and upper respiratory tract infections, including pharyngitis and, occasionally, otitis media or myringitis, which may be bullous. Coryza, sinusitis, and croup are rare. Malaise, fever, and occasionally, headache are nonspecific manifestations of infection. In approximately 10% of patients, pneumonia with cough and widespread rales on physical examination develops within a few days and lasts for 3 to 4 weeks. The cough is nonproductive initially but later may become productive, particularly in older children and adolescents. Approximately 10% of children with pneumonia exhibit a rash, most often maculopapular. Abnormalities detected on radiography vary, but bilateral, diffuse infiltrates are common, and focal abnormalities, such as consolidation, effusion, and hilar adenopathy may occur.

Unusual manifestations include nervous system disease (eg, aseptic meningitis, encephalitis, demyelinating disease, cerebellar ataxia, transverse myelitis, peripheral neuropathy) as well as myocarditis, pericarditis, polymorphous mucocutaneous eruptions (including Stevens-Johnson syndrome), hemolytic anemia, and arthritis. In patients with sickle cell disease, Down syndrome, immunodeficiencies, and chronic cardiorespiratory disease, severe pneumonia with pleural effusion can develop. A substantial proportion of acute chest syndrome and pneumonia associated with sickle cell disease appears to be attributable to M pneumoniae.


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ETIOLOGY: Mycoplasmas, including Mycoplasma pneumoniae, are the smallest free-living microorganisms; they lack a cell wall and are pleomorphic.


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EPIDEMIOLOGY: Mycoplasmas are ubiquitous in animals and plants, but M pneumoniae causes disease only in humans. Mycoplasma pneumoniae is transmissible by respiratory droplets during close contact with a symptomatic person. Outbreaks have been described in hospitals, military bases, colleges, and summer camps. People of . . . [Go to Full Text]


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