Mycoplasma Infections

Mycoplasma Infections

Mycoplasma represents a diverse group of bacteria causing human infections. The commonest one is Mycoplasma pneumoniae, which is the subject of discussion in this writeup. It is a common cause of community acquired respiratory infection and the main cause of atypical pneumonia in children and adults. However, Mycoplasma has been implicated in many extra-pulmonary diseases and complications.

Epidemiology
Mycoplasma infections are very common with prevalence in the population estimated to be about 10%. It is seen more frequently in children but is not uncommon in adults as well. Of interest, the prevalence of Mycoplasma antibodies in patients with Chronic Fatigue Syndrome and Fibromyalgia Syndrome has been reported to be about 50 %.

Treatment

Mycoplasma usually causes “walking pneumonia” and can be treated with antibiotics in an outpatient setting. The drugs that we use include:

Points to Note

Mycoplasma infections are usually not life threatening but can be a significant cause of morbidity and long term disability and ill health.

If you are concerned about Mycoplasma infection, please contact your family physician or call our clinic for an appointment with one of our infectious disease physicians.

Clinical

Mycoplasma has been called an atypical bacteria because it does not behave like a typical bacteria. For one, it cannot be cultured in the normal bacteria culture medium and requires special culture media which is not usually available in most routine commercial laboratories. Diagnosis is often based on the demonstration of recent / new Mycoplasma IgM antibody or high Mycoplasma Antibody titre (especially for relapse). Transmission of the infection is via the airborne route making household contacts at particular high risk of acquiring the infection. The clinical spectrum of disease includes:

  • Atypical pneumonia
  • Tracheobronchitis
  • Ear infections
  • Sinusitis
  • Asymptomatic (20%)
Mycoplasma infection can be complicated by extrapulmonary manifestations which include:

  • Skin rash (erythema multiforme, Stevens-Johnson Syndrome)
  • Arthralgia, arthritis
  • Neurological (ADEM, encephalitis, polyradiculitis, organic brain syndrome)
  • Chronic Fatigue Syndrome
  • Chronic Pain Syndrome
  • Chronic Neurological Syndrome
Some of the postulated mechanisms of illness include:

  • Direct inflammatory response induced by the bacteria
  • Abnormal immune response by the host (patient), autoimmunity type response, host inability to clear infection resulting in chronicity
    or chronic persistent or relapsing infection
  • Vascular occlusion related to hypercoagulable state from infection or associated with COLD agglutinins production

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