Mycoplasma Pneumonia in Children and Adolescents

Practice Gap

Mycoplasma pneumoniae is a frequent cause of respiratory infections, including community-acquired pneumonia, in school-age children. However, as the science surrounding the diagnosis of this pathogen improves, our knowledge of its epidemiology, including asymptomatic carriage, and the management of this disease is evolving.

Objectives

After completing this article, readers should be able to:

1. Understand the microbiology and epidemiology of Mycoplasma pneumoniae infection.

2. Describe the variable clinical presentation of M pneumoniae infection and extrapulmonary manifestations.

3. Understand the difficulties associated with diagnosing infection with M pneumoniae and current recommendations for diagnosis.

4. Appropriately treat patients with suspected Mycoplasma infection.

Clinical Case

A 9-year-old girl presents to her pediatrician with a fever, decreased energy, and a cough for 10 days. She was initially evaluated 4 days ago when she had rhinorrhea, a cough, and decreased energy over the previous week. Her examination at that time was notable only for a mildly erythematous posterior oropharynx and nasal discharge. She was diagnosed as having a viral upper respiratory tract infection, and supportive care measures were recommended. Since that visit, her cough is more persistent and she has developed fevers. On examination her temperature is 100.8°F (38.2°C), heart rate is 100 beats/min, respiratory rate is 40 breaths/min, and oxygen saturation is 90% on room air. She is generally well-appearing. Her physical examination is remarkable for an erythematous posterior oropharynx, nasal discharge, and bilateral diffuse crackles on auscultation of her lungs. What is the next step in diagnosis and management?

Mycoplasma Defined