Mycoplasma pneumoniae pneumonia in children.
- Author:
You Sook YOUN
1
;
Kyung Yil LEE
Author Information
- Publication Type:Review
- Keywords: Mycoplasma pneumoniae; Pneumonia; Macrolides; Drug resistance; Child; Corticosteroids
- MeSH: Adrenal Cortex Hormones; Antibodies; Child; Drug Resistance; Early Diagnosis; Humans; Immunoglobulin M; Immunoglobulins; Korea; Macrolides; Mycoplasma; Mycoplasma pneumoniae; Pneumonia; Pneumonia, Mycoplasma; Polymerase Chain Reaction; Respiratory Distress Syndrome, Adult; Respiratory Tract Infections; Serologic Tests; Treatment Failure
- From:Korean Journal of Pediatrics 2012;55(2):42-47
- CountryRepublic of Korea
- Language:English
- Abstract: Mycoplasma pneumoniae (MP), the smallest self-replicating biological system, is a common cause of upper and lower respiratory tract infections, leading to a wide range of pulmonary and extra-pulmonary manifestations. MP pneumonia has been reported in 10 to 40% of cases of community-acquired pneumonia and shows an even higher proportion during epidemics. MP infection is endemic in larger communities of the world with cyclic epidemics every 3 to 7 years. In Korea, 3 to 4-year cycles have been observed from the mid-1980s to present. Although a variety of serologic assays and polymerase chain reaction (PCR) techniques are available for the diagnosis of MP infections, early diagnosis of MP pneumonia is limited by the lack of immunoglobulin (Ig) M antibodies and variable PCR results in the early stages of the infection. Thus, short-term paired IgM serologic tests may be mandatory for an early and definitive diagnosis. MP infection is usually a mild and self-limiting disease without specific treatment, and if needed, macrolides are generally used as a first-choice drug for children. Recently, macrolide-resistant MP strains have been reported worldwide. However, there are few reports of apparent treatment failure, such as progression of pneumonia to acute respiratory distress syndrome despite macrolide treatment. The immunopathogenesis of MP pneumonia is believed to be a hyperimmune reaction of the host to the insults from MP infection, including cytokine overproduction and immune cell activation (T cells). In this context, immunomodulatory treatment (corticosteroids or/and intravenous Ig), in addition to antibiotic treatment, might be considered for patients with severe infection.
