Complications tableComplication | Timeframe | Likelihood |
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| short term | medium |
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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.[95]Light RW. Parapneumonic effusions and empyema. Proc Am Thorac Soc. 2006;3(1):75-80.
http://www.ncbi.nlm.nih.gov/pubmed/16493154?tool=bestpractice.com
It occurs in up to 30% of cases of Legionella pneumophila pneumonia and in rare cases of Mycoplasma pneumoniae pneumonia.[7]Klement E, Talkington DF, Wasserzug O, et al. Identification of risk factors for infection in an outbreak of Mycoplasma pneumoniae respiratory tract disease. Clin Infect Dis. 2006 Nov 15;43(10):1239-45.
https://academic.oup.com/cid/article/43/10/1239/514997
http://www.ncbi.nlm.nih.gov/pubmed/17051486?tool=bestpractice.com
[96]Shuvy M, Rav-Acha M, Izhar U, et al. Massive empyema caused by Mycoplasma pneumoniae in an adult: a case report. BMC Infect Dis. 2006 Feb 1;6:18.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1397845/
http://www.ncbi.nlm.nih.gov/pubmed/16451727?tool=bestpractice.com
Appropriate antibiotic treatment is essential. If fluid accumulates or does not resolve, then thoracentesis and drainage may be indicated. In severe nonresolving cases, pleural decortication may be required. Pleural effusion |
| short term | medium |
---|
May occur in up to 25% of M pneumoniae patients and is mainly self-limited maculopapular or vesicular rash.[5]Waites KB, Talkington DF. Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev. 2004 Oct;17(4):697-728.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC523564/
http://www.ncbi.nlm.nih.gov/pubmed/15489344?tool=bestpractice.com
Severe cases may include Stevens-Johnson 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.[97]Martínez-Pérez M, Imbernón-Moya A, Lobato-Berezo A, et al. Mycoplasma pneumoniae-induced mucocutaneous rash: a new syndrome distinct from erythema multiforme? Report of a new case and review of the literature. Actas Dermosifiliogr. 2016 Sep;107(7):e47-51.
http://www.ncbi.nlm.nih.gov/pubmed/27040303?tool=bestpractice.com
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. |
| short term | low |
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In up to 7% of patients hospitalized with M pneumoniae, a neurologic 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]Waites KB, Talkington DF. Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev. 2004 Oct;17(4):697-728.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC523564/
http://www.ncbi.nlm.nih.gov/pubmed/15489344?tool=bestpractice.com
Because some of these complications have autoimmune features, any treatment for each individual patient should be tailored according to the specific neurologic syndrome. |
| short term | low |
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Pericarditis is an accumulation of fluid in the pericardial space that is mainly seen in M pneumoniae and L pneumophila infections.[5]Waites KB, Talkington DF. Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev. 2004 Oct;17(4):697-728.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC523564/
http://www.ncbi.nlm.nih.gov/pubmed/15489344?tool=bestpractice.com
[98]Scerpella EG, Whimbey EE, Champlin RE, et al. Pericarditis associated with Legionnaires' disease in a bone marrow transplant recipient. Clin Infect Dis. 1994 Dec;19(6):1168-70.
http://www.ncbi.nlm.nih.gov/pubmed/7888562?tool=bestpractice.com
If abnormalities do not resolve with antibiotic treatment, then the patient may require pericardiocentesis and drainage. Pericarditis |
| long term | low |
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For more than a decade, studies have suggested a possible role of atypical pathogens, mainly Chlamydophila pneumoniae, in progression of atherosclerosis. Further study is needed.[99]Ieven MM, Hoymans VY. Involvement of Chlamydia pneumoniae in atherosclerosis: more evidence for lack of evidence. J Clin Microbiol. 2005 Jan;43(1):19-24.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC540187/
http://www.ncbi.nlm.nih.gov/pubmed/15634945?tool=bestpractice.com
[100]Grayston JT. Chlamydia pneumoniae and atherosclerosis. Clin Infect Dis. 2005 Apr 15;40(8):1131-2.
https://academic.oup.com/cid/article/40/8/1131/320029
http://www.ncbi.nlm.nih.gov/pubmed/15791512?tool=bestpractice.com
[101]Arcari CM, Gaydos CA, Nieto FJ, et al. Association between Chlamydia pneumoniae and acute myocardial infarction in young men in the United States military: the importance of timing of exposure measurement. Clin Infect Dis. 2005 Apr 15;40(8):1123-30.
https://academic.oup.com/cid/article/40/8/1123/319935
http://www.ncbi.nlm.nih.gov/pubmed/15791511?tool=bestpractice.com
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