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March 2010, Volume 40 Number 3 , p 53 - 56


  • Susan Simmons PhD, RN, ARNP-BC


CONSIDERED AN ATYPICAL pneumonia, mycoplasmal pneumonia is one of the most common types of community-acquired pneumonia in otherwise healthy people under age 40. It's caused by Mycoplasma pneumoniae, an interstitial bacterium that spreads in respiratory droplets. Unlike typical community-acquired pneumonia, which is usually caused by pneumococcal pneumonia, it's most likely to strike children and young adults age 5 to 20, and is often mistaken for asthma.1Although most patients with M. pneumoniae don't develop pneumonia, those with comorbid conditions (especially involving the lower respiratory tract) are at risk for serious respiratory distress. With community-acquired infections becoming more prevalent, it's essential to recognize the signs and symptoms early in order to treat the infection before it spreads.Sometimes called walking pneumonia, mycoplasmal pneumonia is most common in the summer and fall. Outbreaks in communities tend to be cyclical, occurring every 3 to 8 years. Hallmarks of the disease are a long, insidious onset and a long, gradual recovery. Wheezing and coughing are also characteristic, explaining why the illness is sometimes misdiagnosed as asthma. Most patients recover without complications in several weeks, but the infection may cause pneumonia in children and acute chest syndrome in patients with sickle-cell disease.1M. pneumoniae has a long incubation period (1 to 4 weeks).2 The gradual onset and length of the illness reflect M. pneumoniae's distinctive properties: * its affinity for both ciliary and nonciliary epithelial cells of the respiratory tract * its ability to produce the damaging oxygen free radicals hydrogen peroxide and superoxide, which damage cells and cause inflammation.1,3Ciliary paralysis, cell damage, and inflammation of the respiratory tract lead to coughing and may result in lower respiratory tract infection.When assessing a patient for possible M. pneumoniae infection, look for the following. * upper

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