As we go into the winter season we expect to see an increase in respiratory infections. One infection we are already seeing a lot across the country including in my community are infections caused by the bacteria Mycoplasma pneumoniae.
Mycoplasma pneumoniae causes mild upper upper respiratory tract infections as well as more serious pneumonias that can be bad enough to put people including otherwise healthy kids in the hospital. Epidemics tend to occur every few years. Outbreaks within schools, households and other environments where people have prolonged contact with each other are common.
People of all ages can be infected with Mycoplasma pneumoniae (M. pneumoniae). Historically we have thought of school age kids and young adults as being most affected. This year however there have been a lot more younger kids in the 2 to 4 year old range getting sick – enough that infectious disease specialists have sent out warnings to the medical providers.
This bacteria often just causes self limiting upper respiratory infections but can also cause what is commonly called “walking pneumonia”. Pneumonia is an infection that involves the lungs, not just the upper airways. “Walking” implies that the symptoms caused by M. pneumoniae are less severe which often is the case – people might be short of breath but they are not bed bound. However for a significant number of unlucky people including otherwise healthy kids and young adults – this infection can be bad enough to require oxygen support and hospitalization. Complications are rare but can be serious.
Mycoplasma pneumoniae is a very interesting bacteria. There are several different species of Mycoplasma that infect humans and other animals. Mycoplasma are the smallest of all bacteria. Mycoplasma differ from other bacteria in a special way. Most bacteria have a “cell wall”. Mycoplasma do not have a cell wall, just a cell membrane.
Antibiotics such as amoxicillin and cephalexin used for common infections like ear infections and strep throat work by inhibiting the building of a bacteria’s cell wall. Since Mycoplasma do not have a cell wall it is impossible for these classes of antibiotics to work for these infections. Not having a cell wall also makes it more difficult for these organisms to be detected using standard cell cultures and staining processes.
Testing for Mycoplasma pneumoniae can be done but often times is not done as these tests are costly. Diagnosis of pneumonia caused by Mycoplasma pneumoniae is typically done based on the pattern of symptoms and physical exam findings.
People with pneumonia caused by Mycoplasma will often have a gradual onset of symptoms 1-4 weeks after being exposed to the bacteria. This differs from influenza which usually has a more abrupt onset. COVID-19 often has a prolonged gradual onset of symptoms as well – often the worst symptoms are in the second week of illness. People suspected of having pneumonia caused by Mycoplasma pneumoniae should be tested for COVID-19. People who get pneumonia from Mycoplasma pneumoniae will often have headache, fever, sore throat and/or fatigue for days before they start coughing a lot. The cough may worsen over several days as the other symptoms peak and then start to go away.
Diagram from uptodate.com for more informaton on symptoms see here and here.
It is important to note that not all people with pneumonia caused by this bacteria will have this typical presentation. Also it is important to note that a cough that persists a week after having a sore throat and fever is more likely from a virus and antibiotics will not help. If you have symptoms that could be from an infection with Mycoplasma pneumoniae you should be evaluated by a medical provider – you should not just start taking antibiotics.
We do not have a vaccine against Mycoplasma pneumoniae, however we do have vaccines against other respiratory infections. Getting vaccinated against those infections will help you keep healthy and less likely to get infected with Mycoplasma pneumoniae.
Babies are routinely vaccinated against common bacterial causes of pneumonia through the Pneumococcal and Haemophilus (Hib) vaccines. They are protected against whooping cough with the pertussis vaccine. Everyone 6 months of age and over can get yearly influenza and COVD-19 vaccines. A vaccine against RSV has been available for 2 years now for some babies as well as for mom while she is pregnant.
Some adults may also be able to get the RSV vaccine depending on age and health status. In a future article in my “Staying in the Game” series I will discuss recent changes in the guidelines about who can or should get the RSV and pneumococcal vaccines. For my last article in that series clinic click here.
I will also be continuing my series of articles on nutrition and fitness. Here are the last 2 articles; Problems with Protein Digestion & Absorption Training 4 Life: 9 Adaptations
If you missed it check out my article on Winning and Integrity.
Thanks for listening. Please share.
Russ
Any opinions stated here should be attributed solely to myself and do not necessarily reflect those of any organization I am a member of or of my employer. As always you should consult with a medical provider regarding personal medical concerns – this article is just for informational purposes and is not intended as personal medical advice.