Mycoplasma pneumoniae causes community-acquired pneumonia and upper respiratory illness.
Infection is often seen in close community settings, such as boarding schools, army bases, universities, and hospitals.
Sexually transmitted genitourinary tract infections can also be caused by some species of Mycoplasma, typically M genitalium.
Diagnosis is made clinically; polymerase chain reaction of nasopharyngeal swab, aspirate or sputum, or cultures can confirm diagnosis.
Treatment for both respiratory and genitourinary infections is usually empirical with a macrolide or tetracycline antibiotic.
Fluoroquinolones may be effective as second-line treatment, or clindamycin in susceptible STDs.
Mycoplasma are a group of bacteria, some of which are pathogenic in humans and animals. Mycoplasma are the smallest free-living organisms, both in size and number of genes, and, unlike many other bacteria, they do not have a cell wall. M pneumoniae is the main human pathogen species of this group, which causes respiratory infections. Other pathogenic species include M genitalium, Ureaplasma species (including U parvum and U urealyticum), and M hominis, which are both commensals and pathogens of the genitourinary tract. Rarely, other species, including M amphoriforme, M fermentans, M penetrans, M pirum, and M faucium, or zoonotic haemotrophic mycoplasmas have been associated with human disease, but the pathogenicity of these is still unknown.
History and exam
Key diagnostic factors
- presence of risk factors
- persistent cough
- dry cough
- prolonged symptoms
- pneumonia on physical examination
- exposure to a person with respiratory tract infection
Other diagnostic factors
- throat involvement
- bullous myringitis
- pelvic pain
- close community settings
- recent exposure
- cigarette smoking
- age <30 years
1st investigations to order
- WBC count
- oxygen saturation
- chest x-ray
Investigations to consider
- polymerase chain reaction
- nasopharyngeal viral cultures
- culture/Gram stain
Ran Nir-Paz, MD
Associate Professor in Medicine
Department of Clinical Microbiology and Infectious Diseases
Hadassah-Hebrew University Medical Center
RNP has received research grants from US-Israel Binational Science Foundation, Hebrew University, Rosetrees Trust, and SpeeDx Ltd. RNP is chair of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Mycoplasma and Chlamydia Infections (ESGMAC). RNP is a consultant for and has stocks in eDAS Healthcare. RNP is an author of several references cited in this topic.
Enno Jacobs, MD
Institute for Medical Microbiology and Hygiene
EJ declares that he has no competing interests.
Laura J. Christie, MD
Pediatric Infectious Disease
California Department of Public Health
Viral and Rickettsial Disease Laboratory
LC declares that she has no competing interests.
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