Chest computed tomography scan shows dense alveolar consolidations in both lower lobes. Legionella pneumonia, Q fever, and psittacosis are atypical … 2015 Aug. 57 (4):773-5. Overview Diagnosis and Tests Management and Treatment Prevention Outlook / Prognosis. [Medline]. Atypical pneumonia makes up a significant proportion of community-acquired pneumonia. Kamizono S, Ohya H, Higuchi S, Okazaki N, Narita M. Three familial cases of drug-resistant Mycoplasma pneumoniae infection. Khan FY, Sayed H. Rhabdomyolysis associated with Mycoplasma pneumoniae pneumonia. [Medline]. Pediatr Int. Persistent cough, and cough with sputum is the most common symptom of bacterial pneumonia.. Rapid mycoplasma culture for the early diagnosis of Mycoplasma pneumoniae infection. December 2015. Comparison of Efficacy of Antimicrobial Agents Among Hospitalized Patients With Mycoplasma pneumoniae Pneumonia in Japan During Large Epidemics of Macrolide-Resistant M. pneumoniae Infections: A Nationwide Observational Study. Acad Radiol. 133(6):1081-90. Structural lung disease with abnormal lung parenchyma affects the pattern of infiltrates. David H Posner, MD Assistant Professor of Medicine, New York University School of Medicine; Assistant Chief of Pulmonary Diseases, Instructor, Intensive Care Unit, Education Coordinator for Pulmonary Fellowship, Lenox Hill HospitalDisclosure: Nothing to disclose. 11 (4):1271-1274. Mycoplasma pneumoniae (see mycoplasma pneumonia) is the causative organism in up to 20% of community acquired pneumonia and is often seen in paediatric populations and young adults 3. Chlamydophila pneumoniae (Chlamydia pneumonia) is the causative organism in up to 10% of community-acqu… Mellick LB, Verma N. The Mycoplasma pneumoniae and bullous myringitis myth. Bilateral lung involvement was seen in 50% of patients. [Medline]. [Medline]. 133(6):1124-5. 2014 Jul-Aug. 34 (4):895-911. High titers of cold agglutinins in patients with primary atypical pneumonia were discovered accidentally. M pneumoniae has a remarkable gliding motility and specialized tip organelles that allows it to burrow between cilia within the respiratory epithelium, eventually causing sloughing of the respiratory epithelial cells. 2009 Oct. 41(4):312-3. In 20% of cases, resolution takes longer than 9 weeks. [Medline]. Rhabdomyolysis: An Unusual Presentation of Mycoplasma pneumoniae Infection in an Adult-A Case Report and Literature Review. 2017 Oct 31. Pneumonia is predominantly a clinical syndrome. 2010 Mar. Satinder P Singh, MD, FCCP Professor of Radiology and Medicine, Chief of Cardiopulmonary Radiology, Director of Cardiac CT, Director of Combined Cardiopulmonary and Abdominal Radiology, Department of Radiology, University of Alabama at Birmingham School of MedicineDisclosure: Nothing to disclose. [Medline]. 225976-overview Atypical (Walking) Pneumonia Menu. 91 (6):E30-1. Ann Lab Med. Many patients infected with M pneumoniae remain asymptomatic, but patients who become symptomatic develop a respiratory infection which can be lingering and quite bothersome. [Medline]. J Clin Lab Anal. Atypical Bacterial Pneumonia. [Medline]. Although M pneumoniae is a common cause of pneumonia, only 5-10% of infected patients actually develop pneumonia. Braz J Infect Dis. However, M pneumoniae can cause severe pneumonia in children and has been associated with acute chest syndrome in patients with sickle cell anemia. J Pediatr. [Medline]. New York: McGraw-Hill; 2005. JAMA. [Medline]. Moon HJ, Yang JK, In DH, Kwun DH, Jo HH, Chang SH. Ultrasonography can help differentiate between consolidation and effusion. (Mycoplasma pneumonia is shown in the image below. Diseases & Conditions, 2002 Korppi M, Don M, Valent F, Canciani M. The value of clinical features in differentiating between viral, pneumococcal and atypical bacterial pneumonia in children. [Medline]. [Full Text]. Smith R, Eviatar L. Neurologic manifestations of Mycoplasma pneumoniae infections: diverse spectrum of diseases. Lung imaging with chest radiography has been the standard method of diagnosing pneumonia; however, lung ultrasonography has the potential to more accurately and efficiently diagnose pneumonia, as well as pleural effusions, pneumothorax, pulmonary embolism, and pulmonary contusions. Residual lung parenchymal scarring can be found, even after the acute infection resolves. [Medline]. 2009 Dec. 15(6):380-3. [Medline]. Khan FY, A yassin M. Mycoplasma pneumoniae associated with severe autoimmune hemolytic anemia: case report and literature review. 1938. However, the study concluded that host immune maturity and not the virulence factor of the organism is a major determinant factor of disease severity. , (A CT scan of Legionella pneumonia is shown in the image below. 23(5):465-6. 2009 Apr. , (A CT scan of chlamydial pneumonia is shown in the image below. Atypical pneumonia. Macrolides in Children With Community-Acquired Pneumonia: Panacea or Placebo?. 2013 May. [Medline]. [15, 16] arthritis, [Medline]. 1944. 111:2377-84. Robbins NM, Kumar A, Blair BM. Immunochromatography test for rapid diagnosis of Mycoplasma pneumoniae infection. A comparative clinical study of macrolide-sensitive and macrolide-resistant Mycoplasma pneumoniae infections in pediatric patients. Mycoplasma pneumoniae (see mycoplasma pneumonia) is the causative organism in up to 20% of community acquired pneumonia and is often seen in pediatric populations and young adults 3. Isozumi R, Yoshimine H, Morozumi M, Ubukata K, Ariyoshi K. Adult community-acquired pneumonia caused by macrolide resistant Mycoplasma pneumoniae. 2012 Sep 22. [Medline]. [Full Text]. Up to 25% of patients may have a small to moderate-sized pleural effusion. 2018. Medscape Education, Advancing the Diagnosis of Pneumonia and Sepsis: Updates for the Critical Care Specialist, 2002 Oishi T, Narita M, Ohya H, et al. Csábi G, Komáromy H, Hollódy K. Transverse myelitis as a rare, serious complication of Mycoplasma pneumoniae infection. Gong L, Zhang CL, Zhen Q. 2009 Feb. 13(1):77-9. 2006 Aug. 19(4):374-8. Chen CJ, Hung MC, Kuo KL, Chung JL, Wu KG, Hwang BT, et al. Clinical, etiologic, and histopathologic features of Stevens-Johnson syndrome during an 8-year period at Mayo Clinic. Pediatrics. Although mycoplasmal pneumonia is common in all age groups, it is most common in the first 2 decades of life, is rare in children younger than five years, and has the highest rate of infection in individuals aged 5-20 years. 2008 May. Song M, Zhang Y, Li S, Zhang C, Tao M, Tang Y, et al. Radiologic resolution of Legionella pneumonia may take 6-12 months. J Comput Assist Tomogr. Agarwal J, Awasthi S, Rajput A, Tiwari M, Jain A. Atypical bacterial pathogens in community-acquired pneumonia in children: a hospital-based study. Daxboeck F. Mycoplasma pneumoniae central nervous system infections.  Immunity after infection with M pneumoniae is not long lasting. Chest CT findings and clinical features in mild Legionella pneumonia. 2013:457161. Colin AA, Yousef S, Forno E, Korppi M. Treatment of Mycoplasma pneumoniae in pediatric lower respiratory infection. Constitutional symptoms often predominate over respiratory findings. Diseases & Conditions, encoded search term (Mycoplasmal Pneumonia) and Mycoplasmal Pneumonia, Hospital-Acquired Pneumonia (Nosocomial Pneumonia) and Ventilator-Associated Pneumonia, Black Race Noted More Prominently in PHI Than White Race, FDA Approves First and Only Treatment for AL Amyloidosis, Many ED Visits May Be Preventable for Patients With NSCLC, Idiopathic Pulmonary Fibrosis: Killer Without a Cause, Pulse Oximeters Miss Low Oxygen Levels Nearly Three Times More Often in Blacks Than Whites, Score Predicts Risk for Ventilation in COVID-19 Patients, Intake of Vitamins A, E and D Tied to Respiratory Health, Stop Prescribing Nocturnal Oxygen to Patients With COPD, Asthma Clinical Practice Guidelines (JSA, 2020). Pediatrics. … [Medline]. Acute cholestatic hepatitis revealing Mycoplasma pneumoniae infection without lung involvement in an adult patient. [Medline]. 2012 Feb. 25(1):77-81. The organism can be excreted from the respiratory tract for several weeks after the acute infection; therefore, isolation of the organism may not indicate acute infection. Legionella pneumophila infection presenting as headache, confusion and dysarthria in a human immunodeficiency virus-1 (HIV-1) positive patient: case report. Li CM, Gu L, Yin SJ, et al. . [Medline]. Wang K, Gill P, Perera R, Thomson A, Mant D, Harnden A. The etiology of bullous myringitis and the role of mycoplasmas in ear disease: a review. AJR Am J Roentgenol. Once found, the area where an effusion occurs can be marked for subsequent diagnostic or therapeutic thoracentesis. [Full Text]. 72(4):204-6. Image in a 66-year-old patient with Legionella pneumonia. Mycoplasma disease and acute chest syndrome in sickle cell disease. Although this patient smokes, this lesion most likely has an inflammatory etiology, given the clinical symptoms and a recent, normal CT scan. 2012 Jun. Radiologic findings alone are not reliable in differentiating pneumonia into typical or atypical forms. With more severe infection, lung cavitation and bulging of the fissure have been reported. Trop Doct. 66:113-120. Therapeutic efficacy of macrolides, minocycline, and tosufloxacin against macrolide-resistant Mycoplasma pneumoniae pneumonia in pediatric patients. 2017 Oct. 59 (10):1123-1125. J Int Med Res. Learreta JA, Durst AC, Barrientos EE. [Medline].  as well as pediatric pneumonia. Klaus-Dieter Lessnau, MD, FCCP Former Clinical Associate Professor of Medicine, New York University School of Medicine; Medical Director, Pulmonary Physiology Laboratory, Director of Research in Pulmonary Medicine, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital 2003 Jul. 234753-overview Reimann HA. Respirology. Palmu AA, Kotikoski MJ, Kaijalainen TH, Puhakka HJ. [Medline].  severe autoimmune hemolytic anemia, [Medline]. Curr Opin Pulm Med. [Medline]. 2000 Jan. 174 (1):37-41. [Medline]. 2010. Mycoplasma pneumoniae is a common cause of community-acquired pneumonia (CAP), and the disease usually has a prolonged, gradual onset. Share cases and questions with Physicians on Medscape consult. Paul Blackburn, DO, FACOEP, FACEP Attending Physician, Department of Emergency Medicine, Maricopa Medical Center 2001 Jun. Antimicrob Agents Chemother. 166 (5):1246-51. , (Scans of atypical bacterial pneumonia are depicted below.). [14, 15] : An indistinct, abnormal opacity on chest radiographs, Patchy, ground-glass, linear, or reticular opacities on chest radiographs, Neutropenia and fever of unknown origin (for which ultra–thin-section CT scanning may be helpful). [Full Text]. [Medline]. Your doctor might call it “atypical pneumonia” because it’s not like more serious cases. How is walking pneumonia treated? Shakeel Amanullah, MD is a member of the following medical societies: American College of Chest PhysiciansDisclosure: Nothing to disclose. A 38-year-old patient with Mycoplasma pneumonia. 2008 Feb. 46(2):727-31. Atypical organisms are generally associated with a milder form of pneumonia, the so-called "walking pneumonia." 2010 Dec. 26(12):966-8. Hong Kong Med J. [Medline]. Luby JP. Todd SR, Dahlgren FS, Traeger MS, Beltrán-Aguilar ED, Marianos DW, Hamilton C, et al. 2016. 21:130-33. However, it tends to be more severe in patients with sickle cell anemia. [Medline]. If the process extends to the pleural space, associated empyema may be present. Chest radiograph shows multifocal, patchy consolidation in the right upper, middle, and lower lobes. Detection of Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella spp. Schulze M, Vogel W, Spira D, Sauter A, Hetzel J, Horger M. Reduced perfusion in pulmonary infiltrates of high-risk hematologic patients is a possible discriminator of pulmonary angioinvasive mycosis: a pilot volume perfusion computed tomography (VPCT) study. [Medline]. Koskiniemi M. CNS manifestations associated with Mycoplasma pneumoniae infections: summary of cases at the University of Helsinki and review. 1938. A report of six cases and review of the literature. [11, 12] immune thrombocytopenic purpura, April 13, 2018; Accessed: December 28, 2018. Bacterial etiology of acute myringitis in children less than two years of age. A Case of a 14-year-old Girl Who Developed Dermatomyositis Associated with Mycoplasma pneumonia Infection. Please confirm that you would like to log out of Medscape. 2009 Oct. 20(7):595-8. Clin Infect Dis. 2009 Sep. 41(3):159-66. [Medline]. Pediatrics. Lee SW, Yang SS, Chang CS, Yeh HJ, Chow WK. [Medline]. [6, 7, 8, 9, 10], Mycoplasma pneumoniae has been identified with an increasing array of illnesses, such as acute hepatitis, Kawai Y, Miyashita N, Kubo M, et al. New Microbiol. 2013 Feb. 51(2):723-4. Reittner P, Müller NL, Heyneman L, Johkoh T, Park JS, Lee KS, et al. Thoracic diseases associated with HIV infection in the era of antiretroviral therapy: clinical and imaging findings.  In about 20% of patients, pleural effusion or hilar adenopathy may be present. 2016 Jan. 96 (1):111-3. In 5-10% of patients (with the rate depending on [emedicine.medscape.com] … Mycoplasma pneumonia and its complications. Pneumonia caused by Mycoplasma pneumoniae infection. Kurata M, Kano Y, Sato Y, Hirahara K, Shiohara T. Synergistic Effects of Mycoplasma pneumoniae Infection and Drug Reaction on the Development of Atypical Stevens-Johnson Syndrome in Adults. [Medline]. The classic etiologic agents of atypical pneumonia are Legionella species, Mycoplasma pneumoniae, and Chlamydia pneumoniae. Clin Chest Med. The use of multiplex real-time PCR improves the detection of the bacterial etiology of community acquired pneumonia. Mayo Clin Proc. Respir Med. Computed tomography (CT) scans are increasingly being used in clinical practice. 65 (11):1837-1842. Walking pneumonia is how some people describe a mild case of pneumonia. Permanent residual fibrosis is observed in as many as 25% of patients. 1993 Aug. 17 Suppl 1:S52-7. Michael Joseph Bono, MD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, Medical Society of Virginia, Society for Academic Emergency MedicineDisclosure: Nothing to disclose. Ear Nose Throat J. ABSTRACT. Chest computed tomography scan in a 45-year-old patient with Chlamydia pneumonia shows a right upper-lobe infiltrate. Kaler J, Mukhtar O, Khan B, Shrestha B, Kaler R, Ting B, et al. Edematous fluid, which may be seen in the alveolus, contains few exudative cells. Okoli K, Gupta A, Irani F, Kasmani R. Immune thrombocytopenia associated with Mycoplasma pneumoniae infection: a case report and review of literature. Kotikoski MJ, Kleemola M, Palmu AA. [Medline]. [Full Text]. Pediatr Neurol. 10:CD009175. These infections can be severe and may have concomitant bacterial etiologies. Paul Blackburn, DO, FACOEP, FACEP is a member of the following medical societies: American College of Emergency Physicians, Arizona Medical Association, American College of Osteopathic Emergency Physicians, American Medical AssociationDisclosure: Nothing to disclose. In summer, this organism may cause as many as 50% of all pneumonias. The most common atypical pneumonias are caused by three zoonotic pathogens, Chlamydia psittaci (psittacosis), Francisella tularensis (tularemia), and Coxiella burnetii (Q fever), and three non-zoonotic pathogens, … Rahimian M, HosseiniB M. Serological study of Bordetella Pertussis, Mycoplasma Pneumonia and Chlamydia Pneumonia in Iranian hajj pilgrims with prolonged cough illnesses: A follow-up study. Michael Joseph Bono, MD, FACEP Professor of Emergency Medicine, Vice Chair, Emergency Medicine Residency Program, Department of Emergency Medicine, Eastern Virginia Medical School [Full Text]. [Medline]. [Medline]. Analysis of clinical value of CT in the diagnosis of pediatric pneumonia and mycoplasma pneumonia. Rales heard over the involved lobe or segment 3. Diagram of the Mollicutes class, to which the Mycoplasma genus belongs. 42(6):477-82. 14 (3):183-94. The role of eosinophil cationic protein in patients with Mycoplasma pneumoniae infection. Atypical pneumonia is an infection affecting the lower respiratory tract. 2000 Apr. Chest computed tomography scan shows ill-defined, airspace infiltrate in the left lower lobe. Mina Farhad, MD, PhD is a member of the following medical societies: Radiological Society of North AmericaDisclosure: Nothing to disclose. In rare instances, Legionella infection is associated with cavitation and a masslike appearance. 2014 Jun. 2012 May. Copete AR, Aguilar YA, Rueda ZV, Vélez LA. Atypical bacterial pneumonia generally is characterised by a symptom complex that includes headache, low-grade fever, cough, and malaise. 24(4):224-9. 111:2377-84. Exp Ther Med. 2013 Feb. 131(2):251-3. Long et al found that lung ultrasound can help diagnose adult pneumonia with a high accuracy. [Medline]. Azumagawa K, Kambara Y, Murata T, Tamai H. Four cases of arthritis associated with Mycoplasma pneumoniae infection. Cunha BA. Diagn Microbiol Infect Dis. This phase is characterized by engorgement of the arterial blood vessels. 2018:6897975. [Medline]. [Medline]. 2002 Transmission of the organism is person-to-person by infected respiratory droplets. J Infect Chemother. 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