Mycoplasma

Mycoplasma refers to a type of bacteria that can cause various infections in humans. These infections most commonly affect the respiratory system, leading to conditions like "walking pneumonia" or bronchitis. Other Mycoplasma species can cause sexually transmitted infections. While symptoms can range from mild to severe, Mycoplasma infections are generally treatable with specific antibiotics.

What is Mycoplasma?

Mycoplasma is a unique type of bacteria that can cause infections in different parts of the body, most notably the respiratory and urogenital systems. Unlike most other bacteria, Mycoplasma lacks a rigid outer layer called a cell wall. This characteristic is important because it means certain common antibiotics, which target cell walls, are not effective against Mycoplasma infections.

Mycoplasma are among the smallest known bacteria. Their unique structure, specifically the absence of a cell wall, allows them to change shape and makes them resistant to a class of antibiotics that typically work by breaking down bacterial cell walls, such as penicillin. One of the most well-known species is *Mycoplasma pneumoniae*, which is a common cause of respiratory tract infections. These infections can range from mild upper respiratory symptoms to more serious conditions like bronchitis (inflammation of the airways) and pneumonia (lung infection). Another important species is *Mycoplasma genitalium*, which is primarily transmitted through sexual contact. This bacterium can cause sexually transmitted infections (STIs) affecting the genital and urinary tracts in both men and women. Other Mycoplasma species exist but are less commonly associated with significant human disease.

Symptoms

Symptoms of Mycoplasma infections vary depending on the specific type of Mycoplasma and the part of the body affected. Respiratory infections, often caused by *Mycoplasma pneumoniae*, typically involve a persistent cough, fever, and fatigue. Sexually transmitted infections, caused by *Mycoplasma genitalium*, may cause discharge or painful urination, though often there are no noticeable symptoms at all.

For respiratory infections caused by *Mycoplasma pneumoniae*, symptoms usually develop slowly, often starting with a sore throat, headache, and general feeling of being unwell (malaise). A dry cough is a hallmark symptom, which can become persistent and last for several weeks or even months. Fever, chills, and fatigue are also common. When *Mycoplasma pneumoniae* causes pneumonia, it is often referred to as "walking pneumonia." This term is used because the symptoms are typically milder than other types of pneumonia, allowing affected individuals to continue with their daily activities, even though they have a lung infection. Infections with *Mycoplasma genitalium* often have no symptoms, especially in the early stages. When symptoms do occur, they can include painful urination (dysuria) and discharge from the penis or vagina. In women, it can also lead to pelvic pain, especially during sex, and abnormal vaginal bleeding. In men, it may cause inflammation of the urethra (urethritis).

Causes & risk factors

Mycoplasma infections are caused by exposure to the bacteria. *Mycoplasma pneumoniae* spreads through respiratory droplets when an infected person coughs or sneezes. *Mycoplasma genitalium* is transmitted through unprotected sexual contact. Risk factors generally involve close contact with an infected individual or engaging in behaviors that facilitate transmission.

The primary cause of *Mycoplasma pneumoniae* infection is inhaling respiratory droplets containing the bacteria. These droplets are released into the air when an infected person coughs, sneezes, or talks. The bacteria can then be inhaled by others nearby, leading to infection. Risk factors for *Mycoplasma pneumoniae* infection include living or working in crowded environments such as schools, dormitories, nursing homes, or military barracks. Close, prolonged contact with an infected person increases the likelihood of transmission. While anyone can get infected, young adults and school-aged children are particularly susceptible. *Mycoplasma genitalium* infection is caused by unprotected sexual contact with an infected partner. This includes vaginal, anal, and oral sex. Risk factors for *Mycoplasma genitalium* include having multiple sexual partners, not using condoms consistently and correctly, and having other sexually transmitted infections.

How it's diagnosed

Diagnosing Mycoplasma infections typically begins with a review of your symptoms and a physical examination. Because symptoms can resemble other common infections, specific laboratory tests are often needed to confirm the presence of Mycoplasma bacteria. These tests may include swabs or blood tests to detect the bacteria or antibodies against them.

When you see a doctor for suspected Mycoplasma, they will ask about your symptoms, medical history, and may perform a physical exam, listening to your lungs if a respiratory infection is suspected. However, symptoms alone are often not enough to definitively diagnose Mycoplasma, as they can mimic other viral or bacterial infections. To confirm a diagnosis, your doctor may order specific laboratory tests. For respiratory infections, a swab from your throat or nose might be taken. For sexually transmitted infections, a swab from the urethra, cervix, or rectum may be collected. These samples are then tested using molecular methods, such as polymerase chain reaction (PCR), which can detect the genetic material (DNA) of the Mycoplasma bacteria. Blood tests can sometimes be used to look for antibodies against Mycoplasma, but these are less common for acute diagnosis as it can take time for antibodies to develop. A chest X-ray may be performed if pneumonia is suspected, which can show inflammation in the lungs, but it cannot specifically identify Mycoplasma as the cause.

Treatment options

Mycoplasma infections are treated with specific antibiotics. It is crucial to note that antibiotics like penicillin are ineffective because Mycoplasma bacteria lack a cell wall, which these drugs target. Your doctor will prescribe an appropriate antibiotic, and it is important to complete the entire course, even if your symptoms improve sooner, to ensure the infection is fully cleared.

The primary treatment for Mycoplasma infections is a course of antibiotics. Because Mycoplasma bacteria do not have a cell wall, antibiotics that work by disrupting cell walls, such as penicillin and cephalosporins, are not effective. This is a key difference from many other bacterial infections. Instead, doctors typically prescribe antibiotics from classes such as macrolides (e.g., azithromycin, clarithromycin), tetracyclines (e.g., doxycycline), or fluoroquinolones (e.g., levofloxacin). The choice of antibiotic depends on the specific Mycoplasma species, the site of infection, and local patterns of antibiotic resistance. In addition to antibiotics, your doctor may recommend supportive care to help manage symptoms. This can include getting plenty of rest, drinking fluids, and using over-the-counter medications like acetaminophen or ibuprofen for fever and pain. Always follow your doctor's instructions regarding medication and complete the full course of antibiotics to prevent the infection from returning or developing resistance.

Recovery & outlook

With appropriate antibiotic treatment, most people recover fully from Mycoplasma infections. However, symptoms, particularly a cough from respiratory infections, can sometimes linger for several weeks or even months after the bacteria have been cleared. While rare, complications can occur, especially in individuals with weakened immune systems or if the infection is left untreated.

For most individuals, the outlook for Mycoplasma infections is good, with full recovery expected after completing the prescribed course of antibiotics. It is common for some symptoms, such as a persistent cough from *Mycoplasma pneumoniae*, to take a longer time to resolve completely, even after the infection itself has been treated. While uncommon, complications can arise. For respiratory infections, these might include severe pneumonia, asthma attacks, or, in very rare cases, more serious issues affecting the brain (encephalitis), heart (myocarditis), or joints (arthritis). These complications are more likely to affect individuals with underlying health conditions or compromised immune systems. For *Mycoplasma genitalium* infections, if left untreated, complications can be significant. In women, it can lead to pelvic inflammatory disease (PID), which can cause chronic pelvic pain, infertility, or an increased risk of ectopic pregnancy (where a fertilized egg implants outside the uterus). In men, untreated infection can cause inflammation of the epididymis (epididymitis), leading to pain and swelling in the testicles. Early diagnosis and treatment are important to prevent these potential long-term issues.

When to see a doctor

You should see a doctor if you experience persistent or worsening symptoms that suggest a Mycoplasma infection, especially if they are severe. Seek immediate medical attention for symptoms like significant difficulty breathing, chest pain, a high fever (over 102°F or 39°C), or confusion. Prompt medical evaluation can lead to timely diagnosis and appropriate treatment.

It is advisable to contact your doctor if you have symptoms that do not improve within a few days, or if they worsen. This is especially true if you have a persistent cough, fever, or feel unusually tired. Early diagnosis can help ensure you receive the correct treatment and prevent potential complications. Seek urgent medical care if you experience any of the following severe symptoms: significant shortness of breath or difficulty breathing, chest pain, a high fever that does not respond to over-the-counter medications, confusion, or unusual drowsiness. These could be signs of a more serious infection or a complication requiring immediate attention. If you have symptoms of a sexually transmitted infection, such as unusual discharge, painful urination, or pelvic pain, it is important to see a doctor promptly. Timely testing and treatment for *Mycoplasma genitalium* can prevent the spread of the infection and reduce the risk of long-term health issues.

Frequently asked questions

Is Mycoplasma contagious?

Yes, Mycoplasma infections are contagious. *Mycoplasma pneumoniae*, which causes respiratory infections, spreads through respiratory droplets from coughing or sneezing. *Mycoplasma genitalium*, a sexually transmitted infection, spreads through unprotected sexual contact.

Can Mycoplasma be prevented?

Prevention depends on the type of Mycoplasma. For respiratory Mycoplasma, practicing good hand hygiene, avoiding close contact with sick individuals, and covering coughs and sneezes can help. For *Mycoplasma genitalium*, consistent and correct use of condoms during sexual activity is the most effective prevention method.

How long does Mycoplasma last?

The duration of Mycoplasma infection varies. With appropriate antibiotic treatment, the bacteria are usually cleared within a week or two. However, symptoms, especially a cough from respiratory Mycoplasma, can sometimes linger for several weeks or even months after the infection has been treated.

Is Mycoplasma a virus or bacteria?

Mycoplasma is a type of bacteria, not a virus. This distinction is important because bacterial infections are treated with antibiotics, while viral infections are not. Mycoplasma's unique lack of a cell wall means it requires specific types of antibiotics.

Can Mycoplasma cause long-term problems?

Usually, Mycoplasma infections do not cause long-term problems if treated promptly and correctly. However, in rare cases or if left untreated, complications can occur. For example, *Mycoplasma genitalium* can lead to pelvic inflammatory disease in women, potentially causing infertility or chronic pain.

Why is Mycoplasma pneumonia called 'walking pneumonia'?

Mycoplasma pneumonia is often called 'walking pneumonia' because its symptoms are typically milder than other forms of pneumonia. People with this condition may feel unwell but are often able to continue with their daily activities, rather than being bedridden, which is common with more severe pneumonia.

Sources

• MedlinePlus — Mycoplasma
• Mayo Clinic — Mycoplasma
• Cochrane Library — Mycoplasma