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Mycoplasma Infection
Mycoplasma pneumoniae is a small, atypical bacteria that causes a variety of infections in otherwise healthy individuals. This microbe is considered "atypical" because it lacks a standard cell wall--a fact that contributes to its resistance to standard antibiotic therapy. In most cases, infection with this agent will result in a mild upper respiratory infection ("cold") similar to that caused by a virus. Mycoplasma does, however, account for up to 25% of community-acquired pneumonia and the symptoms in this case will be more severe. Other respiratory infections caused by mycoplasma include bronchitis and laryngitis. It can also cause infections outside of the pulmonary system such as: meningitis, encephalitis, pericarditis, hepatitis, and hemolytic anemia. Common symptoms of the more common respiratory infection include: headache, malaise, fever, chills, and a dry hacking cough. In some patients the cough can become more chronic and last 4-6 weeks. Associated otitis media is not uncommon and will appear in a patient that also complains of an earache. More rare symptoms include pleurisy, a "sharp" chest pain made worse when breathing in. Some patients will have asthma-like wheezing with the accompanying shortness of breath. Evaluation will include physical examination and chest x-ray to omit the possibility of pneumonia. Blood tests may include CBC and serologic testing for the mycoplasma organism (antigen-antibody test). EKG may be done if the physician suspects pericarditis. Sputum culture can be performed to confirm the diagnosis, but the results are often not completed for 7-10 days. Treatment of choice includes the administration of the antibiotic erythromycin for 10-14 days. A cough suppressant containing codeine may also be indicated. Patients should not smoke while they are attempting to recover from this infection. Fever control can be achieved with aspirin, acetaminophen, or ibuprofen. Those patients who demonstrate asthma-like symptoms (wheezing) may require treatment with a bronchodilator (e.g. Proventil Inhaler). Those with marked shortness of breath or demonstrable poor arterial blood gas analysis will require treatment in the hospital.
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