The Dept of Anaesthesia & Intensive Care, CUHK thanks

for an unrestricted education grant
BASIC instructor/provider course, Hong Kong, July 2nd-4th
Other upcoming courses
Home Feedback Contents


Up CAP Fungal pneumonia Guidelines HAP Mycoplasma Pneumocystis jiroveci

Mycoplasma pneumoniae pneumonia

Causes spectrum of disease from inapparent infection, mild afebrile URTI to severe pneumonia.

Clinical features

- not sufficiently distinctive to permit early definitive diagnosis to be made
- shares features of other non-bacterial pneumonias in that generalised symptoms (eg malaise and headache) often precede chest symptoms by 1-5 days and chest X-ray changes develop before sign become apparent


- usually only 1 lower lobe affected
- patchy opacities most usual finding
- bilateral in approx. 20%
- pleural effusions unusual


- variable but often protracted
- cough, abnormal chest signs and XR changes may persist for several weeks. Organisms may persist in respiratory secretions despite antibiotics
- in children infection occasionally characterised by prolonged illness with paroxysmal cough followed by vomiting
- very severe infections are associated with immunodeficiency or sickle cell anaemia
- death rare

Extra-pulmonary manifestations


- myocarditis
- pericarditis
- <5% patients


- erythema multiforme
- Stevens-Johnson
- other rashes
- 25% patients


- anorexia, nausea, vomiting, transient diarrhoea in 14-44%
- hepatitis
- pancreatitis


- tubo-ovarian abscesses (rare)
- acute glomerulonephritis


- cold agglutinin production in 50%
- cold AIHA (IgM)
- thrombocytopaenia
- intravascular coagulation


- myalgia, arthralgia 14-45%
- arthritis


- meningitis, meningoencephalitis 6-7%
- ascending paralysis
- transient myelitis
- cranial nerve palsy
- polio-like illness


- bullous myringitis


- tetracycline or erythromycin

©Charles Gomersall, April, 2014 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
Copyright policy    Contributors