Clinical Features and Complications

Clinical Features

Mycoplasma pneumoniae infections can occur in the upper or lower respiratory tract. The bacterium can also cause a wide array of extrapulmonary manifestations without obvious respiratory disease. Therefore, patients may have a highly variable presentation. The incubation period is generally between 1 to 4 weeks; however, shorter and longer durations have been documented.

Infection most commonly results in:

• Tracheobronchitis
• Pharyngitis
• Malaise
• Fever
• Cough
• Headache

Onset can be gradual and subacute, slowly progressing to a higher fever and a persistent cough. While the disease can persist for weeks or months, it is frequently mild and self-resolving. The organism may persist for several weeks in the oropharynx despite completion of recommended antimicrobial therapy and resolution of clinical symptoms.

Younger patients often manifest with different clinical characteristics than patients over 5 years old. For example, the infection may run subclinical, be mild, and not result in pneumonia. Infections in younger patients are often characterized by coryza and wheezing without concomitant fever, and sometimes include diarrhea and vomiting.

Clinical Complications

Severe complications can occur that result in hospitalization and sometimes death. Complications that have been reported include:

• Severe pneumonia
• Exacerbation of asthma
• Encephalitis
• Hemolytic anemia
• Renal dysfunction
• Gastrointestinal complaints
• Erythema multiforme, Stevens-Johnson syndrome, or toxic epidermal necrolysis

References

• Waites KB, Atkinson TP. The role of mycoplasma in upper respiratory infections. Curr Infect Dis Rep. 2009;11:198–206.
• Waites KB, Talkington DF. Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev. 2004;17:697–728.