Mycoplasma Pneumonia signs, symptoms and treatment in brief.

1. MYCOPLASMA
PNEUMONIA

2. Introduction
• Mycoplasma species are the smallest free-living
organisms. (150-250 nm)
• Pleomorphic organism
• unlike bacteria, lacks a cell wall,
• unlike viruses, does not need a host cell for replication.
• Prokaryotes - lack a cell wall - Lack of a reaction to Gram
stain and lack of susceptibility to many antimicrobial
agents
• Usually associated with mucosal surfaces, residing
extracellularly in the respiratory and urogenital tracts.
• Mycoplasma pneumoniae, Mycoplasma hominis,
Mycoplasma genitalium, and Ureaplasma species.

4. Pathophysiology
• The Mycoplasma organism produces a protein that allows
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attachment to a receptor on the respiratory epithelium.
Gliding motility and specialized filamentous tips - burrow
between cilia within the respiratory epithelium
Inhibition of ciliary movement
Sloughing of the respiratory epithelial cells
M.pneumoniae Pathogenesis in respiratory tract is due to
• Selective affinity for respiratory epithelial cells
• Ability to produce hydrogen peroxide

5. Epidemiology
• One of the common causes of acquired pneumonias in
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healthy patients. < 40 years.
Common in all age groups
Rare in <5 yeas old children
Highest rates are seen in 5-20 year age group.
The incubation period is 1-3 weeks.
They are spread by large particles by aerosol to close
contacts.

6. Presentation
• Disease of gradual and insidious onset of several days to
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weeks.
Fever
Malaise
Persistent, slowly worsening dry cough
Headache
Chills, not rigors
Scratchy sore throat
Sore chest and tracheal tenderness (result of the
protracted cough)

7. Presentation
• Less common symptoms include:
• Ear pain
• Muscle aches
• Pleuritic chest pain (rare)
• Extrapulmonary symptoms are thought to be autoimmune
induced
• rashes
• Stevens Johnson Syndrome
• meningoencephalitis
• arthritis, gastrointestinal symptoms

8. Examination
• A nontoxic general appearance
• Normal lung findings with early infection but rhonchi,
rales, and/or wheezes several days later
• Erythematous tympanic membranes - an uncommon but
unique sign

9. Investigations
• Laboratory tests are generally of limited benefit
• Elevated ESR
• Normal or elevated WBC
• Sputum Gram stains and cultures not helpful
• M pneumoniae lacks a cell wall and cannot be stained
• difficult to culture and requires 7-21 days to grow
• Polymerase chain reaction (PCR) - accurately diagnose
atypical pneumonia
• used for epidemiologic studies
• not used in clinical practice

10. Radiographic findings
• Multifocal, bilateral diffuse infiltrates most frequent
• occasionally have lobar pneumonia picture.
• Pleural effusions are not rare
• The x-ray often looks worse than the clinical picture.

11. Treatment
• Suggested to teat for 7-10 days.
• Empiric antimicrobial therapy must be comprehensive and
should cover all likely pathogens in the context of the clinical
setting.
• Antimicrobials against M pneumoniae are bacteriostatic-not
bactericidal
• Erythromycin - Will also be effective against other community
acquired infections such as pneumococcal pneumonia.
• Clarithromycin and Azithromycin
• Tetracylcines in patients > 10 years old (Doxycycline)
• Levofloxacin

12. THANK YOU