Mycoplasma Pneumonia

Mycoplasma pneumonia (Otherwise known as “Walking Pneumonia” or “Atypical Pneumonia”) is likely a term you may have heard your pediatrician say right now! It is a common cause of pneumonia in kids over 5 years of age but can be seen in younger kids as well.  It causes a prolonged cough and sometimes a fever and fatigue.  Most commonly parents will say that “their child has been coughing for weeks and is just so tired”. 

Symptoms:

• First 1-2 weeks: (kids will have some but may not have all)

  • Dry Cough 

  • Fever (many kids)

  • Low energy

  • Sore throat (half of kids)

  • Shortness of breath 

  • Sometimes: rash, earache, stomach pain, vomiting, or diarrhea

• Next 2-6 weeks:

  • Cough can linger for weeks even with treatment

How does it spread? 

• respiratory droplets (eg via coughing, sneezing)

  • usually requires prolonged close contact

• After exposure, symptoms can take up to 3-4 weeks to develop.

Complications:

Typically it is a mild illness, but sometimes it is not.  This year, many more kids have needed hospitalization for oxygen and respiratory help. 

How is it Diagnosed?

This is often a clinical diagnosis means its based on symptoms and a physical exam. It is similar to other viral symptoms. Sometimes a PCR test will be ordered of a nasal or throat swab.  Chest X-rays are sometimes helpful but not always necessary. 

How is it treated?

Most kids will have a mild infection that will go away without antibiotics.  However, the cough can be disruptive to sleep, school and other activities. 

• We treat with Azithromycin (an anitbiotic) in children in most cases

• Most kids start feeling better in 24-48 hours. 

Prevention:

We do not know how long mycoplasma is contagious. Most experts think that it is less likely to be contagious about 2 weeks after start of symptoms. 

So what can you do?

• Frequent handwashing for 20 seconds using soap and water

• Face masks if desired

• Distancing from others who are sick 

When to call the pediatrician:

• Breathing difficulty with rapid breathing, retractions, pauses in breathing, nasal flaring, grunting or wheezing. 

• Feeding difficulty, not taking in enough fluids

• Change in color like blue or paleness

• Excessive fatigue

• Fever persistent after 4-5 days. 

• No improvement 24-48h after starting antibiotics

Does my child need to stay home from school?

Yes. Keep them home until they have been on antibiotics for at least 24 hours, are feeling better (able to stay hydrated, acting more like themselves) and fever free without medications for >24 hours.