Mycoplasma pneumonia
Walking pneumonia; Community-acquired pneumonia - mycoplasma; Community-acquired pneumonia - atypical
Pneumonia is inflamed or swollen lung tissue due to infection with a germ.
Mycoplasma pneumonia is caused by the bacteria Mycoplasma pneumoniae (M pneumoniae).
This type of pneumonia is also called atypical pneumonia because the symptoms are different from those of pneumonia due to other common bacteria.
The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.
Erythema multiforme lesions are circular and may appear in concentric rings (often called target lesions). Target lesions may also be associated with other medical conditions such as herpes infection, streptococcal infection, tuberculosis (TB), or as a reaction to chemicals or medications.
Erythema multiforme lesions are often referred to as target lesions because of the concentric rings the lesions produce. The target appearance is well demonstrated in this photograph.
The red spots on this person's back appear where blisters (bullae) caused by Erythema multiforme have ruptured and the overlying skin removed (denuded). The resulting lesions are yellow-crusted ulcers (erosions). Erythema multiforme may be associated with herpes simplex infection, mycoplasma pneumonia, or other medical conditions such as streptococcal infection, tuberculosis (TB), or may result from exposure to chemicals or medications.
This picture shows diffuse redness (erythema) and scaling on the arm.
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Everyone coughs from time to time. You might pick up a cold, have an allergy, or just get a tickle from something irritating your throat. But if you're really hacking and coughing up yellow or green mucus, and you've also got a fever, chills, and shortness of breath, you may have picked up a more serious infection, called pneumonia. And sometimes pneumonia's symptoms aren't as obvious. Pneumonia is caused by an infection in your lung. Bacteria or viruses like these can sometimes get into your lungs through your nose or mouth and make you sick. You're more likely to get pneumonia if you've got a problem with your immune system that makes it harder to fight off infections. You're also at greater risk if you've got a lung disease like COPD or cystic fibrosis, you've recently had the flu, or you're exposed to cigarette smoke. People who live in nursing homes are also more likely to get pneumonia. With pneumonia, you may cough up greenish or yellow phlegm. You also may run a fever and have the chills. Pneumonia can make it hard to breathe. You may feel like you've run up a flight of stairs when you were just sitting still. Your doctor can tell that you have pneumonia and not just a cold by listening with a stethoscope for crackle sounds in your chest. You may need a chest x-ray or blood tests to know for sure that you have pneumonia. If bacteria caused your pneumonia, your doctor can give you antibiotics, drugs that kill bacteria. Keep taking the antibiotic until you finish the whole prescription so you don't re-infect yourself. To help loosen all of that mucus clogging your lungs, breathe in the warm mist from a humidifier and drink plenty of water. Take it easy too. Don't try to run back to work and infect everyone else. Rest until you feel better. Whatever you do, don't smoke, it will only make your pneumonia worse. If your pneumonia is really severe or you have another serious health problem, your doctor may recommend that you get treated in the hospital. While there, you'll get antibiotics and fluids through a vein. You may also be given oxygen to help you breathe easier. The best way to deal with pneumonia is to avoid getting it in the first place. Older adults, children, and people with serious conditions like diabetes, asthma, cancer, and emphysema should talk to their doctor about getting vaccinated against pneumonia and the illnesses that cause it. Once you get treated, your pneumonia should clear up within a couple of weeks. Your doctor may want to check your lungs to make sure they're clear. Sometimes pneumonia can lead to serious lung complications, so call your doctor right away if your breathing problems get worse, you have chest pain, or you cough up blood.
Causes
Mycoplasma pneumonia usually affects people younger than 40.
People who live or work in crowded areas such as schools and homeless shelters have a high chance of getting this condition. But many people who get sick with it have no known risk factors.
Symptoms
Symptoms are often mild and appear over 1 to 3 weeks. They may become more severe in some people.
Common symptoms include any of the following:
- Chest pain
- Chills
- Cough, usually dry and not bloody
- Excessive sweating
- Fever (may be high)
- Headache
- Sore throat
Less common symptoms include:
- Ear pain
- Eye pain or soreness
- Muscle aches and joint stiffness
- Neck lump
- Rapid breathing
- Skin lesions or rash
Exams and Tests
People with suspected pneumonia should have a complete medical evaluation. It may be hard for your health care provider to tell whether you have pneumonia, bronchitis, or another respiratory infection, so you may need a chest x-ray.
Depending on how severe your symptoms are, other tests may be done, including:
- Complete blood count (CBC)
- Blood tests
- Bronchoscopy (rarely needed)
- CT scan of the chest
- Measuring levels of oxygen and carbon dioxide in the blood (arterial blood gases)
- Nose or throat swab to check for bacteria and viruses
- Open lung biopsy (only done in very serious illnesses when the diagnosis cannot be made from other sources, so very rarely needed)
- Sputum tests to check for mycoplasma bacteria
In many cases, it is not necessary to make the specific diagnosis before starting treatment.
Treatment
To feel better, you can take these self-care measures at home:
- Control your fever with aspirin, NSAIDs (such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children because it may cause a dangerous illness called Reye syndrome.
- Do not take cough medicines without first talking to your provider. Cough medicines may make it harder for your body to cough up the extra sputum.
- Drink plenty of fluids to help loosen secretions and bring up phlegm.
- Get a lot of rest. Have someone else do household chores.
Antibiotics are used to treat atypical pneumonia:
- You may be able to take antibiotics by mouth at home.
- If your condition is severe, you will likely be admitted to a hospital. There, you will be given antibiotics through a vein (intravenously), as well as oxygen.
- Antibiotics might be used for 2 weeks or more, although usually fewer days are needed.
- Finish all the antibiotics you've been prescribed, even if you feel better. If you stop the medicine too soon, the pneumonia can return and may be harder to treat.
Outlook (Prognosis)
Most people recover completely without antibiotics, although antibiotics may speed recovery. In untreated adults, cough and weakness can last for up to a month. The disease can be more serious in older adults and in those with a weakened immune system.
Possible Complications
Complications that may result include any of the following:
- Ear infections
- Hemolytic anemia, a condition in which there are not enough red blood cells in the blood because the body is destroying them
- Skin rashes
When to Contact a Medical Professional
Contact your provider if you develop a fever, cough, or shortness of breath. There are many causes for these symptoms. The provider will need to rule out pneumonia.
Also, call if you have been diagnosed with this type of pneumonia and your symptoms become worse after improving first.
Prevention
Wash your hands often, and have other people around you do the same.
Avoid contact with other sick people.
If your immune system is weak, stay away from crowds. Ask visitors who have a cold to wear a mask.
Do not smoke. If you do, get help to quit.
Get a flu shot every year. Ask your provider if you need a pneumonia vaccine.
References
Baum SG, Goldman DL. Mycoplasma infections. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 301.
Dockrell DH, Ho A, Gordon SB. Community-acquired pneumonia. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 46.
Holzman RS, Simberkoff MS, Leaf HL. Mycoplasma pneumoniae and atypical pneumonia. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 183.
Version Info
Last reviewed on: 7/31/2022
Reviewed by: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
