How does mycoplasma pneumonia differ from ordinary pneumonia?
With typical pneumonia caused by pneumococcus, the disease begins abruptly: high fever, chills, cough with sputum, severe weakness. Mycoplasma infection behaves differently. It develops slowly, often disguised as a lingering cold or bronchitis, and on x-ray the changes are subtle and do not coincide with the severity of the cough. Mycoplasma lives on the surface of the cells of the respiratory tract and does not have a cell wall - this is why drugs that destroy this wall are powerless, and the choice of antibiotic is fundamentally different.
- Gradual onset instead of abrupt onset
- Temperature is often moderate
- Cough is dry, paroxysmal, hacking
- Little or no sputum
- Health suffers less than expected with pneumonia
- Changes in the image are often bilateral and unclear
How do people get infected and who gets sick more often?
The pathogen is transmitted by airborne droplets during close and prolonged contact - at home, in the classroom, in the dormitory, in the barracks. A fleeting meeting is usually not enough for infection, so outbreaks stretch for weeks and gradually cover a family or team. From contact to the first complaints, it takes from several days to three weeks, and the person is contagious even before the cough appears. Stable lifelong immunity is not formed after the disease, repeated episodes are possible.
- School-age children and teenagers
- Young adults
- People living or working in close groups
- Family members of the sick person
- Patients with bronchial asthma and chronic bronchitis suffer more severe infections
Symptoms
The disease often starts as a common respiratory infection: sore throat, nasal congestion, headache, aches, low fever. After a few days, the main symptom appears - an obsessive dry cough, which worsens at night and interferes with sleep. Sometimes ear pain, rash, joint pain, and nausea occur. In children, wheezing exhalation, similar to obstructive bronchitis, is possible. It is the duration of the cough, and not its strength, that most often brings the patient to the doctor.
- Dry paroxysmal cough for more than two weeks
- Low-grade fever, less often fever
- Headache and severe weakness
- Sore throat and hoarseness
- Night coughing attacks
- Sometimes rash, pain in the ear, joints
Diagnostics
The basis is an examination and x-ray of the chest: with pneumonia, focal or interstitial changes are visible on the image, even if wheezing is faintly heard. In case of mycoplasma infection, a general blood test often remains almost unchanged, and C-reactive protein increases moderately. PCR of a nasopharyngeal smear and IgM and IgG antibodies in the blood help confirm the pathogen, and antibodies do not appear immediately and are often assessed over time. In severe cases or an unclear picture, the doctor prescribes a computed tomography scan of the lungs.
- Examination with auscultation of the lungs
- Chest X-ray in two projections
- Complete blood count and C-reactive protein
- PCR of nasopharyngeal swab for mycoplasma
- Antibodies IgM and IgG to mycoplasma
- Pulse oximetry, if necessary - computed tomography
Treatment and recovery
Treatment is prescribed by a doctor. The antibiotic is selected from groups that act on pathogens without a cell wall: in children these are usually macrolides; in adults, tetracyclines or respiratory fluoroquinolones are also possible. The course cannot be interrupted at the first improvement. At the same time, drinking plenty of fluids, cool, moist air and rest are important. Antitussives are not recommended without a doctor's prescription. Most patients are treated at home, and hospitalization is necessary for shortness of breath, low blood oxygen saturation, severe concomitant diseases and in young children.
- The antibiotic and course duration are determined by the doctor.
- Drink plenty of fluids and rest in the first days
- Air ventilation and humidification
- Control examination, if necessary, a repeat image
- Breathing exercises during the recovery period
- Quitting smoking, including passive smoking