"Following infection, non-productive cough slowly increases over a period of 2-3 weeks becoming incessant and persisting for weeks. Although spontaneous resolution is the rule, < 25% develop extrapulmonary invasion or autoimmune disease which can be severe 9."
"Subclinical haematological disease may affect < 50%:"
"Mycoplasma pneumoniae is a common cause of community-acquired pneumonia (CAP). It is ‘atypical’ with regard to resistance to beta-lactam antibiotics, paucity of sputum, minimal leucocytosis and rarity of lobar consolidation 10."
"M. pneumoniae is one of the most frequent causes of CAP in otherwise healthy adults until age 40 and is particularly common between the ages of 5 and 20 years accounting for around 40% of CAP 7 in this age-group."
"Transmission is human to human by respiratory droplets induced by coughing and the incubation period is long, averaging 2-3 weeks. Up to 10% of those infected develop pneumonia. Outbreaks commonly occur in schools, colleges, hospitals, aged-care facilities and in closed populations such as military establishments or prisons. Epidemics may occur every 3-5 years. Lingering cough is typical and organisms continue to be excreted after clinical recovery. M. pneumoniae is also a frequent commensal in the respiratory tract."
"Mycoplasma pneumoniae is a tiny parasitic bacterium in the class mollicutes (Latin for soft skin). They lack a cell wall, making them resistant to penicillins and invisible on Gram stain. M. pneumoniae causes upper and lower respiratory tract disease. It binds to ciliated epithelium preventing ciliary clearance. Hydrogen peroxide production causes oxidative damage and apoptosis. Pneumonia severity depends on the maturity of the host immune system."
"Community-acquired distress syndrome (CARDS) exotoxin is a unique virulence factor of M. pneumoniae."
"Bronchitis and peribronchitis with interstitial thickening, alveolar filling and areas of atelectasis are typical, similar to other atypical pneumonias. Fatal pneumonia is rare and is associated with oedema, mucosal ulceration, haemorrhage, ARDS, thrombosis, DIC and multi-organ failure. Fulminant infection accounts for less than 0.5% of cases."
"Confirmation of the diagnosis is helpful to track outbreaks or to investigate autoimmune complications such as haemolytic anaemia, myocarditis or encephalitis. DNA testing using nucleic acid amplification techniques (NAATs) and real-time PCR is rapid and reliable if there are sufficient organisms in the sample. A positive result can indicate active or recent infection or the presence of commensal or non-viable organisms."
"Viral and other atypical pneumonias such as Chlamydia pneumonia which cause a bronchitis/bronchopneumonia pattern. Hilar lymphadenopathy with patchy lung opacity could mimic TB."
"A small proportion of patients may develop abscess, necrotising pneumonia, fibrosis, bronchiectasis, bronchiolitis obliterans, ARDS, respiratory failure and extrapulmonary complications."
"peri-bronchial thickening"
"Bronchitis and peribronchitis with interstitial thickening, alveolar filling and areas of atelectasis are typical, similar to other atypical pneumonias. Fatal pneumonia is rare and is associated with oedema, mucosal ulceration, haemorrhage, ARDS, thrombosis, DIC and multi-organ failure. Fulminant infection accounts for less than 0.5% of cases."
"nausea, vomiting and diarrhoea"
"A small proportion of patients may develop abscess, necrotising pneumonia, fibrosis, bronchiectasis, bronchiolitis obliterans, ARDS, respiratory failure and extrapulmonary complications."