Infection

Question

What does infection with mycoplasma do to a patient with CF and is this easy to treat?

Answer

Mycoplasma pneumoniae is the full name of one of the smallest bacteria that can cause infections in people. People get infected with this bacteria after direct contact with respiratory secretions (saliva) of other people who had this infection. After contamination with this bacteria the incubation time (the time till the first symptoms) is about 3 weeks.
Often the infection will have very little consequences and will thus pass unnoticed. Especially children and young adults can develop disease after contamination. Most commonly mycoplasma causes airway infection with lots of coughing, a runny nose, sore throat and sometimes fever. Rather rarely a pneumonia with high fever, coughing, wheezing, shortness of breath and abnormal lung auscultation will occur. In school age children and young adults Mycoplasma infection is one of the most frequent causes of pneumonia (up to half of all episodes). M. pneumoniae also can cause exacerbations of asthma and it is thought to cause chronic airway disease in a small number of children.
Apart from airway symptoms other disease signs can be present such as: skin rash, joint pain or arthritis, diarrhea and abdominal pain. Other complications are rather exceptional.
To what extend a treatment with antibiotics will diminish the symptoms is not entirely clear. In most cases especially healthy children will heal by themselves. Antibiotics such as macrolides (clarithromycine or azitromycine), tetracyclines (doxycycline) or fluorochinolones (levofloxacine or moxifloxacine) probably shorten the disease.
There is no evidence that M. pneumoniae infections run a different course in patients with CF. Of course, just like viral infections, Mycoplasma can cause an exacerbation of respiratory symptoms: more cough, more sputum, new abnormalities on chest X-ray and/or lower lung function. This is best treated by intensifying chest physiotherapy and antibiotics geared against the bacteria usually found in the patient.
Only if symptoms are suggestive of Mycoplasma infection will these need identification by means of a special test on a sample of the airway (PCR). If infection is confirmed, additional antibiotics active against M. pneumoniae can be prescribed.
Prof. Kris De Boeck

08.05.2012