Atypical pneumonia
Complications
Pleural/parapneumonic effusion is an accumulation of fluid and inflammatory cells caused by adjacent lung infection or due to invasion of the pleural space by the pathogen.[94] It occurs in up to 30% of cases of Legionella pneumophila pneumonia and in rare cases of Mycoplasma pneumoniae pneumonia.[7][95]
Appropriate antibiotic treatment is essential. If fluid accumulates or does not resolve, then thoracentesis and drainage may be indicated. In severe non-resolving cases, pleural decortication may be required.
May occur in up to 25% of M pneumoniae patients and is mainly self-limited maculopapular or vesicular rash.[5]
Severe cases may include Stevens-Johnson's syndrome and ulcerative stomatitis. The term Mycoplasma-induced rash and mucositis has been used to describe the rash as it can be difficult to classify it as erythema multiforme or Stevens-Johnson syndrome.[96]
Because the main cause for the rash is probably systemic spread of the pathogen to the skin, appropriate antibiotic treatment is the treatment of choice.
In up to 7% of patients hospitalised with M pneumoniae, a neurological complication develops. These occur up to 2 weeks after the onset of infection and may include encephalitis, meningitis, cerebellar syndrome, cranial nerve palsies, and Guillain-Barre syndrome.[5]
Because some of these complications have autoimmune features, any treatment for each individual patient should be tailored according to the specific neurological syndrome.
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