Debunking the myths about Mycoplasma

What is mycoplasma?

Mycoplasma pneumonia (MP) is a contagious respiratory infection that spreads easily through contact with respiratory fluids.

MP is known as an atypical pneumonia and is sometimes called “walking pneumonia.” It spreads quickly in crowded areas, such as schools, college campuses, and nursing homes. When an infected person coughs or sneezes, moisture containing the MP bacteria is released into the air. Uninfected people in their environment can easily breathe the bacteria in.

What are the symptoms?

The pneumonia itself is a disease of slow onset and may include symptoms of fever, malaise, dry persistent cough, a scratchy sore throat, headache, and a sore chest due to the protracted cough. The main symptoms that linger after the period expected for common colds are a dry, persistent cough and fatigue.

If you are suffering from these symptoms and especially if they have lasted longer than you would expect with a common cold, then you should see a doctor who can decide on a plan of treatment based on your symptoms and a full examination.

How is it spread?

The infection is spread by droplets from the nose and throat of infected people, especially after prolonged contact. This means outbreaks in schools and families are not uncommon.

I have heard mycoplasma is common in Singapore, but I had not heard of it before moving here?

MP is one of the most common causes of pneumonia outside hospitals worldwide, especially in otherwise healthy patients under 40. This demographic correlates with the expatriate demographic  in Singapore. Infection is most common in the first two decades of life, but rare in children under 5.

Symptoms can appear several weeks after infection and last longer than flu or viral pneumonias. It is also known as an “atypical pneumonia”.

I have a sore throat and a bad cough. Could this be mycoplasma? Should I have a blood test?

Only 5-10% of patients who are infected actually develop MP. Also, as the organism can be excreted from the respiratory tract for several weeks after the acute infection, isolation of the organism in a positive lab result may not indicate acute infection.

It is worth noting that the antibody level in your blood test can remain elevated for up to 18 months after contracting the infection, so a positive antibody level does not always indicate an current infection. Also, this being such a common infection that one might have caught the infection in the past without a confirmed diagnosis, which would render the blood tests results as not definitive or useful.

Are antibiotics must be needed to treat this infection?

Treatment with antibiotics is sometimes recommended, but as most cases are mild, this is often not necessary. The symptoms are generally mild and patients can still function reasonably well without treatment.  In almost all patients a full recovery is expected.

What can I do to prevent catching mycoplasma?

Covering the mouth and nose when coughing and sneezing and washing hands carefully afterwards helps prevent spread.

Interesting Facts about Mycoplasma

  1. Mycoplasma is caused by the infective organism M pneumoniae. This was first isolated from cattle in 1898 and first described in humans in the USA in 1938, when it was initially thought to be a virus. This is a slightly unusual organism in that, unlike bacteria, it lacks a cell wall and, unlike viruses, it does not need a host for replication. It is one of the smallest known free-living forms of life.
  2. The organism has evolved to be highly specialized and can burrow between cilia in the respiratory cells of humans. Cilia are tiny hairs that act as filters in the air passages of the respiratory tract. They move back and forward with inhaled air, pushing foreign matter towards the nostrils where it is blown out or excreted through the gut. This movement of cilia is inhibited by the infective organism and therefore an intermittent cough develops, as the body is forced to clear excess foreign matter and debris from the lungs.

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