Pediatric Respiratory Infections by Mycoplasma pneumoniae

Kyung-Yil Lee

Disclosures

Expert Rev Anti Infect Ther. 2008;6(4):509-521. 

In This Article

Abstract and Introduction

Mycoplasma pneumoniae is one of the most common agents of community-acquired pneumonia in children and young adults. Although M. pneumoniae is a small bacterium that can reproduce in an artificial culture medium and is known to be sensitive to certain antibiotics in vitro as well as in vivo, the immunopathogenesis of M. pneumoniae in the human host is not fully understood. The epidemiologic characteristics, including periodic epidemics, and some clinical characteristics of M. pneumoniae are similar to those observed in systemic viral infections. Many experimental and clinical studies have suggested that the pathogenesis of lung injuries in M. pneumoniae infection is associated with a cell-mediated immune reaction, including high responsiveness to corticosteroid therapy. This paper presents an overview of M. pneumoniae infections, with emphasis on epidemiology, pathogenesis and treatment.

Mycoplasma pneumoniae is an important causative organism of respiratory infections in children and young adults. M. pneumoniae infections display a spectrum of symptoms and signs, ranging from asymptomatic infection to severe and potentially fatal pneumonia or extrapulmonary manifestations.[1,2,3]M. pneumoniae pneumonia has been reported in 10-40% of cases of community-acquired pneumonia and shows an even higher incidence during epidemics.[4,5,6,7,8]M. pneumoniae is a small bacterium that can be artificially cultured and is very sensitive to certain antibiotics in in vitro assays. However, the immunopathogenesis of M. pneumoniae in humans is still poorly understood. Children have a relatively well-equipped adaptive immune system at birth, but some immune functions mature during childhood. The interaction between an infectious agent and the maturing immune system may result in the appearance of different age-related phenotypes.[9] The epidemiologic characteristics, including periodic epidemics, and some clinical characteristics of M. pneumoniae infection, including the appearance of lymphopenia with anergy to tuberculin skin testing and extrapulmonary manifestations, are similar to those observed in systemic viral infections, such as measles.[10,11,12] Experimental and clinical evidence supports the idea that the pathogenesis of lung injuries in M. pneumoniae infection is associated with cell-mediated immunity, including high responsiveness to corticosteroid therapy.[10,13] In this paper, a brief review of infections due to M. pneumoniae is presented from the standpoints of bacteriology, epidemiology, pathogenesis, diagnosis, clinical features and therapy, with the emphasis on the epidemiology and pathogenesis of cell mediated-immunity, and corticosteroid therapy.

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