mycoplasma

see also:

• clinically important bacteria

• a genus of bacteria that lack a cell wall around their cell membrane and thus are not affected by penicillins or cephalosporins
• usual antibiotic Rx are with macrolide antibiotics but resistance is increasing
• if a patient does not respond appropriately to a macrolide, a fluoroquinolone should be added to the treatment regimen
• patients with significant Mycoplasma hepatitis may be considered for a renally excreted fluoroquinolone rather than a hepatic metabolised macrolide, although either class can cause hepatotoxicity, although antibiotic induced fulminant hepatic failure is very rare
• they are amongst the smallest of bacterial species and are typically 0.1 micron in diameter
• can survive without oxygen

• a common cause of "atypical pneumonia" acquired in the community accounting for ~40% of cases, particularly in children and the elderly
  • also causes tracheobronchitis (esp. children), wheeze, headache, myalgias and URTI
  • ~25% also develop extrapulmonary symptoms such as autoimmune responses, central nervous system complications, and dermatological disorders
  • 20% develop abnormal LFTs, and 2-5% of cases present as hepatitis in which case average C reactive protein (CRP) is 140 instead of 70 for M.pneum without hepatitis ¹⁾
• exclusively parasitizes the respiratory tract epithelium of humans
• has never been isolated as a free-living organism due to its dependence upon the host for survival thus spread is via droplets to those in close and prolonged contact such as households, schools, nursing homes.
• Dx Mycoplasma throat swab PCR
• see wikipedia

• formerly was part of erythema multiforme but now recognised as its own entity
• see https://dermnetnz.org/topics/mycoplasma-pneumoniae-infection

• lives on the ciliated epithelial cells of the urinary and genital tracts in humans as well as throat and anus
• it is a co-factor in HIV transmission
• has been regarded as “normal flora” in many women but is now regarded as a cause of sexually transmitted infections (STDs/STIs) with an incubation period of perhaps 1-3wks
• can become symptomatic causing:
  • urethritis
  • cervicitis
  • pelvic inflammatory disease (PID)
• suspected to play a role in development of some cancers such as prostate cancer, ovarian tumours, and lymphoma
• treatment is usually single dose of azithromycin as well as partners being treated and then re-tested after 1 month to ensure clearance
• resistance to azithromycin is developing rapidly since ~2007 when the 1st cases in Australia were found to be resistant, in 2017, 50-80% had become resistant!