Mycoplasma pneumonia natural history, complications and prognosis

Following transmission, Mycoplasma incubation period is approximately 1 to 4 weeks. During this time, the patient remains asymptomatic. Onset of symptoms can be gradual and subacute. If left untreated, Mycoplasma pneumonia slowly progresses, and patients typically report high-grade fever and a persistent cough. While the disease can persist for weeks or months, it is frequently mild and self-resolving. In children < 5 years of age, the infection may run subclinical, mild, and non-pneumonia courses. Complications of Mycoplasma pneumonia include otitis, hemolytic anemia, asthma exacerbation, bronchiectasis, Swyer-James syndrome (post-infectious obliterative bronchiolitis), acute kidney injury, Guillain-Barré syndrome, Stevens-Johnson syndrome, pericarditis, myocarditis, transverse myelitis, or meningoencephalitis. Prognosis is usually good, and the majority of patients recover completely even without antimicrobial therapy. Elderly individuals and patients with sickle cell disease and other immunocompromised patients are at increased risk of developing complications of Mycoplasma pneumonia.

• Following transmission, Mycoplasma incubation period is approximately 1 to 4 weeks. During this time, the patient remains asymptomatic.^[1]

• Onset of symptoms can be gradual and subacute. If left untreated, Mycoplasma pneumonia slowly progresses, and patients typically report high-grade fever and a persistent cough.^[1]
• While the disease can persist for weeks or months, it is frequently mild and self-resolving. The organism may persist for several weeks in the oropharynx despite resolution of clinical symptoms.^[1]

• Younger patients often manifest with different clinical characteristics than patients over 5 years old.^[1]
• The infection may run subclinical, mild, and non-pneumonia courses.
• Infections in younger patients are often characterized by coryza and wheezing without concomitant fever, and sometimes include diarrhea and vomiting.
• Persistent cough is common during convalescence.^[1]

Complications of Mycoplasma pneumonia include:^[1][2]

• Hemolytic anemia
• Asthma exacerbation
• Acute kidney injury
• Guillain-Barré syndrome
• Erythema multiforme, Stevens-Johnson syndrome, or toxic epidermal necrolysis
• Encephalitis or meningoencephalitis
• Transverse myelitis
• Arthropathy
• Pericarditis
• Myocarditis
• Bronchiectasis
• Swyer-James syndrome (post-infectious obliterative bronchiolitis)
• Bullous myringitis (possible)

• Prognosis is usually good, and the majority of patients recover completely even without antimicrobial therapy.^[1]
• Elderly individuals and patients with sickle cell disease and other immunocompromised patients are at increased risk of developing complications of Mycoplasma pneumonia.^[1]