What are extrapulmonary complications of Mycoplasma infections (Mycoplasma pneumoniae)?

Updated: Feb 15, 2019
  • Author: Ken B Waites, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Extrapulmonary complications may occur simultaneously with the onset of respiratory manifestations or as long as several days later. These complications may predominate to the extent that physicians may overlook a primary respiratory tract infection. Less than 10% of cases of M pneumoniae infections are associated with nonrespiratory illnesses, with the exception of various skin rashes, nausea, vomiting, and diarrhea, which may occur more often. [15]

When extrapulmonary manifestations occur, however, they clearly can complicate the diagnosis and the recovery; they also make hospitalization more likely. Thus, a careful history and physical examination are essential, and follow-up is indicated.

Researchers believe that an autoimmune response plays a role in some extrapulmonary complications, but, because M pneumoniae has been isolated directly from cerebrospinal, pericardial, and synovial fluids and from other extrapulmonary sites, always consider direct invasion by this organism.

Extrapulmonary manifestations may include the following:

  • Meningoencephalitis

  • Ascending (ie, Guillain-Barré) paralysis

  • Transverse myelitis

  • Myopericarditis

  • Cardiac arrhythmia

  • Raynaud phenomenon

  • Hemolytic anemia

  • Disseminated intravascular coagulation

  • Renal failure

  • Arthritis

  • Erythema multiforme (ie, Stevens-Johnson syndrome)

  • Erythema nodosum

  • Urticaria

  • Ulcerative stomatitis

  • Nausea

  • Vomiting

  • Diarrhea


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