How Do I Choose the Best Mycoplasma Pneumoniae Treatment?

Mycoplasma pneumoniae (M. Pneumonia) is a pathogen of human mycoplasma pneumonia. The pathological changes of mycoplasma pneumonia are mainly interstitial pneumonia, sometimes accompanied by bronchial pneumonia, which is called primary atypical pneumonia. It is mainly transmitted by droplets, with an incubation period of 2 to 3 weeks, with the highest incidence in adolescents. The clinical symptoms are relatively mild, or even asymptomatic. If there are general respiratory symptoms such as headache, sore throat, fever, and cough, there are also individual death reports. It can happen all year round, but mostly in autumn and winter.

Mycoplasma pneumoniae

Mycoplasma pneumoniae (M. Pneumonia) is a pathogen of human mycoplasma pneumonia. The pathological changes of mycoplasma pneumonia are mainly interstitial pneumonia, sometimes accompanied by bronchial pneumonia, which is called primary atypical pneumonia. It is mainly transmitted by droplets, with an incubation period of 2 to 3 weeks, with the highest incidence in adolescents. The clinical symptoms are relatively mild, or even asymptomatic. If there are general respiratory symptoms such as headache, sore throat, fever, and cough, there are also individual death reports. It can happen all year round, but mostly in autumn and winter.

Mycoplasma pneumoniae symptoms

Mycoplasma pneumonia is prominently manifested as paroxysmal irritating cough

After mycoplasma pneumoniae infects the human body, after 2 to 3 weeks of incubation period, clinical manifestations appear, and about 1/3 of the cases can be asymptomatic. It starts slowly, with symptoms such as sore throat, headache, fever, fatigue, muscle aches, loss of appetite, nausea, and vomiting. The fever is generally moderate, and obvious respiratory symptoms appear after 2 to 3 days, which is prominently represented by paroxysmal irritating cough, which is heavy at night, coughing a small amount of mucus or mucopurulent sputum, and sometimes blood in the sputum may Dyspnea and chest pain. Fever can last for 2 to 3 weeks, and cough can still be left after normal body temperature.

Although patients with Mycoplasma pneumonia have more severe symptoms, chest examinations usually have no obvious abnormal signs. Nasal congestion, runny nose, and moderate congestion of throat. Ear drums often have congestion, and about 15% have tympanitis. The cervical lymph nodes can become swollen. A small amount of pleural effusion occurs in about 10% to 15% of cases. In addition to the manifestations of the respiratory system, mycoplasma pneumonia can be accompanied by multiple system and multiple organ damage. Skin damage can manifest as maculopapular erythema, nodular erythema, and herpes. Gastrointestinal system showed vomiting, diarrhea, and liver damage. Hematological damage is more common than hemolytic anemia. Central nervous system damage can be seen in multiple radiculitis, meningoencephalitis, and cerebellar injury. Cardiovascular diseases are occasionally myocarditis and pericarditis.

Chest X-rays of patients with Mycoplasma pneumonia vary widely, and the lesions can be mild or extensive. The signs are slight and the chest radiography is prominent, which is one of the characteristics of this disease. Blood tests for white blood cells vary in height, most of which are normal and sometimes high.

The clinical manifestations and chest X-ray examination of Mycoplasma pneumonia are not characteristic, and the diagnosis cannot be made based on the clinical manifestations and chest X-ray examination alone. To make a clear diagnosis, detection of the pathogen is required. At present, the diagnosis of domestic Mycoplasma pneumonia mainly relies on serological tests.

Mycoplasma pneumoniae transmission

The pathogenicity of Mycoplasma pneumoniae first adheres to the surface of the host cell through its top structure, and extends the microtubules into the cell to absorb nutrients and damage the cell membrane, and then releases nucleases, hydrogen peroxide and other metabolism to cause lysis and epithelial cells Swelling and necrosis. The antibodies induced by the body may also be involved in the pathological damage mentioned above. SlgA secreted by the respiratory tract has a certain defensive effect on reinfection, but it is not strong enough.

The diagnosis of Mycoplasma pneumoniae mainly relies on isolation culture and serological tests. Specimens can be obtained from sputum or pharyngeal specimens of suspect patients and inoculated in agar medium containing serum or yeast extract. After 5 to 10 days, the presence of round roof-like colonies with a diameter of 30 to 100 um was observed. After several passages, it can become a typical "poached egg" -like colony, and can adsorb a variety of animal red blood cells and tracheal epithelial cells, HeLa cells, etc., and such adsorption can be inhibited by specific antibodies. After preliminary identification of the isolated mycoplasma through morphology, hemolysis, and biochemical reactions, specific antisera are required for further growth inhibition tests and metabolic inhibition tests. Using the serum of patients with mycoplasma lipid antigen as a complement binding test, the recovery period is more than 4 times higher than the acute period, which has diagnostic value. Indirect immunofluorescence test and indirect hemagglutination ELISA can also be used to detect specimens. In addition, one-third to three-quarters of patients' serum can be non-specific agglutination with human O-type red blood cells at 4 ° C (called the "condensation agglutination test"), disappear at 37 ° C, and peak at one week of illness. This method is simple and helpful for diagnosis.

Treatment can be erythromycin, tetracycline and chloramphenicol.

Mycoplasma dead and live attenuated vaccines are still being tested.

Beware of Mycoplasma Pneumonia in Cold Season

As the weather became colder, mycoplasma pneumonia patients gradually increased in the hospital. Mycoplasma pneumonia is also called "primary atypical pneumonia". In 2003, the "SARS" caused by the coronavirus was suspected to be mycoplasma pneumonia from the beginning. So what exactly is mycoplasma pneumonia?

Mycoplasma pneumoniae is a more common pathogen causing pneumonia. It is common in children and adolescents.

Both bacterial and viral infections can cause pneumonia, and pneumonia caused by Mycoplasma pneumoniae is called Mycoplasma pneumonia.

More than 60 years ago, foreign scholars described a pneumonia of unknown pathogen, which is different from the typical pneumonia caused by Streptococcus pneumoniae, and does not respond to penicillin treatment, so it is called "atypical pneumonia". With the deepening of research, people have realized that the pathogen causing this pneumonia is Mycoplasma pneumoniae.

Mycoplasma pneumoniae is different from ordinary bacteria and viruses. It is smaller than bacteria but larger than viruses. It is the smallest microorganism that can live independently. Mycoplasma pneumonia can occur throughout the year, more common in autumn and winter. It is transmitted by air droplets from the mouth and nasal secretions of patients in the acute phase, causing respiratory infections. Its incidence is mainly related to increased indoor activities and close contact. Mycoplasma infection can also manifest as pharyngitis and tracheobronchitis.

Mycoplasma pneumoniae treatment

Treatment of patients with Mycoplasma pneumonia

Mycoplasma pneumonia is mainly treated with antibacterial drugs. Because cough is the most prominent clinical manifestation of mycoplasma pneumonia, small doses of antitussives and expectorants can be given appropriately. Patients with severe hypoxic symptoms should be given oxygen in time. For severe asthma, bronchodilators can be used. Adrenal corticosteroids can be applied to patients with acute and severe mycoplasma pneumoniae or lung lesions with atelectasis, pulmonary fibrosis, bronchiectasis, or extrapulmonary complications.

Treatment of Mycoplasma pneumoniae infection in children

For mild Mycoplasma pneumoniae infection, related drugs can be taken orally. These drugs include erythromycin and a new generation of macrolides, such as azithromycin, clarithromycin and roxithromycin.

The pediatric clinic in China has chosen to administer intravenous routes too much. Azithromycin intravenous preparations are overused. The 2005 edition of the "Pharmacopoeia of the People's Republic of China" indicates that the clinical use of azithromycin clearly states: <6 months in children with CAP, the efficacy and safety of azithromycin have not been established, and should be used with caution . Intravenous azithromycin may cause severe anaphylactic shock. Severe MP infection can be administered intravenously during the disease stage, but it should be switched to gastrointestinal administration in a timely manner and sequential therapy should be adopted. Intravenous erythromycin and azithromycin have adverse reactions such as gastrointestinal discomfort, and pediatric clinics have added vitamin B6, vitamin K1, sodium bicarbonate, 654-1 and other drugs, but there is no evidence to support the effectiveness of this empirical medication And the addition of drugs may change the blood pH value and affect the efficacy of erythromycin and azithromycin. These drugs have enhanced activity under slightly alkaline conditions.

The course of mycoplasma infection varies depending on the lesion. Mild upper respiratory tract infections are usually 10-14 days. It should be noted that after treatment, mycoplasma still persists in respiratory secretions in some children for several months, causing recurrence and spread. The recommended course of treatment for Mycoplasma pneumonia: 2-3wk in light cases, 4wk in severe cases, and individual cases will be longer, depending on the specific condition.

Available drugs and their dosages

The minimum bacteriostatic mass concentration of erythromycin: mycoplasma is 0.0156tzg / mL, and the ratio of intracellular and extracellular levels is 6.6: 1. Children 30-50mg / (kg · d), orally in 3 to 4 times. It can also be administered intravenously. MP patients are the strongest indication of intravenous erythromycin.

Roxithromycin: 5-10 mg / (kg · d) in children, taken orally in two divided doses.

Azithromycin: 10 mg / (kg · d) in children, once orally. The effective tissue level can be maintained for 7 days after 3 days of oral administration. Therefore, it is discontinued for 4 days as a course of treatment. The scheme generally adopted abroad is: 10 mg / kg on the first day, 5 mg / kg on the second to fifth days, and the total dose is still 30 mg / kg. Clinical overuse of azithromycin intravenous preparations should be corrected. Severe MP pneumonia and pleurisy can be administered intravenously in the acute phase of the disease, but sequential therapy should also be adopted and timely converted to VI medication.

Clarithromycin: The dosage is 10-15 mg / (kg · d), and it is taken orally twice. Spiramycin, josamycin, etc. have been used less in pediatrics. ^[1]

Mycoplasma pneumoniae prevention

Drink warm water in dry and cold seasons, strengthen exercise, and ventilate the room

Mycoplasma infection can cause a pandemic, so care should be taken to isolate the respiratory tract. In autumn and winter, windows should be opened regularly to keep room air fresh. Drink plenty of warm water, it is advisable to eat easily digestible and nutritious foods. Develop more outdoor activities and physical exercises, especially strengthen breathing exercises to improve respiratory function. When going out in cold seasons or sudden climate changes, you should add clothes in time to prevent colds. Macrolide antibiotics are commonly used anti-mycoplasma drugs.