Mycoplasma infection in lower right lung. Tanaka H, Openi CC BY 4.0

Definition

Mycoplasma is an infection with the bacterium "Mycoplasma pneumonia ”, most often in children and young adults. This is not a classic ”Opportunistic infection"But by a weakened immune system as during immunosuppressive, anti-rheumatic treatment, by organ transplantation or by HIV infection, mycoplasma infection can become severe. The infection causes throat and lung inflammation, but can rarely spread to multiple internal organs in vulnerable individuals.

It has been discussed whether mycoplasma contributes to the development of arthritis (rheumatoid arthritis) without this being proven (reference: Chu KA, 2019).

• The symptoms may resemble rheumatic fever in children (reference: Relevant M, 1981), otherwise not rheumatic to expect.

Occurrence

Most common among pupils, military and students in the autumn and winter months.

Symptoms

• Absence of symptoms occurs (asymptomatic infection)
• Influenza-like
• Sore throat and hoarseness
• Runny nose
• Ear pain
• About 10% develops pneumonia (pneumonia)
  • Dry cough is typical
• Unusual
  • Hemolysis (Blood, rarely clinically significant)
  • Rash / eczema (including Stevens-Johnson syndrome).
  • Cardiac Muscle inflammation Myocarditis
  • Heart Pouch Inflammation (Pericarditis)
  • Brain inflammation  encephalitis

Diagnosis

The symptoms alone are not typical enough to warrant diagnosis

• Multiplex PCR examination is best early in the disease
• Serology tests (antibody, IgM) are not specific, can only be used late in the course and used little
• Cold agglutinin may be in blood test, but may also occur in other conditions
• CT examination of lungs often shows small, non-specific changes
  • Thickened bronchial wall early in the course of the disease
  • Small knots
  • Matt Glass
  • Seals

Treatment

• Macrolides (azithromycin, clarithromycin eller erythromycin)
  • Oral azithromycin over 5 days (500 mg first dose, then 250 mg daily for 4 days).
• Doxycycline or fluoroquinolones are alternatives
  • Doxycycline or fluoroquinolone is given over 7-14 days

Differential diagnoses: (Other atypical pneumonia causes):

• Mycoplasma pneumoniae
• Chlamydia pneumoniae
• Legionella

Literature

• Parrot GL, 2016
• Tanaka H, ​​2016 (Radiographic lung symptoms)
• Miyashita N, 2009 (Radiographic lung symptoms)
• Wikipedia

Opportunistic infections, BINDEVEVSSYKDOMMER.no

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