Mycoplasmosis (mycoplasma infection)

Mycoplasmosis (mycoplasmal infection) - anthroponous infectious diseases caused by the bacteria of the genera Mycoplasma and Ureaplasma, characterized by the defeat of various organs and systems (respiratory, genitourinary, nervous and other systems).

Distinguish:

1. Mycoplasmosis is respiratory (mycoplasma-pneumonia infection);
2. Mycoplasmosis urogenital (non-gonococcal urethritis, ureaplasmosis and other forms) is considered in the national guidelines on dermatovenereology.

ICD-10 codes

• J15.7. Pneumonia caused by Mycoplasma pneumoniae.
• J20.0. Acute bronchitis caused by Mycoplasma pneumoniae.
• B96.0. Mycoplasma pneumoniae (M. Pneumoniae) as a cause of diseases classified elsewhere.

Epidemiology

The source of the pathogen is a sick person with a manifest or asymptomatic form of M. Pneumoniae infection (it can be secreted from pharyngeal mucus for 8 weeks or more from the onset of the disease even in the presence of antimycoplasmic antibodies and despite effective antimicrobial therapy). Transient carrier M. Pneumoniae is possible .

The mechanism of transmission is aspiration, carried out mainly by airborne droplets. To transmit the pathogen requires a fairly close and long-term contact.

[1], [2], [3], [4], [5], [6], [7],

Causes of mycoplasmosis

Mycoplasmas are Mollicutes class bacteria : an agent of respiratory mycoplasmosis is mycoplasma of the species Pneumoniae of the genus Mycoplasma. The absence of the cell wall causes a number of properties of mycoplasmas, including pronounced polymorphism (rounded, oval, filiform forms) and resistance to beta-lactam antibiotics. Mycoplasmas multiply by binary fission, or due to desynchronization of cell division and DNA replication, extend to form filamentous, mycelial-like forms that repeatedly replicate with the genome and subsequently separate into coccoid (elementary) bodies.

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Pathogenesis of Mycoplasma Infection

M. Pneumoniae falls on the surface of the mucous membranes of the respiratory tract. Penetrates the mucociliary barrier and is firmly attached to the membrane of epithelial cells by means of terminal structures. Incorporation of the sections of the exciter membrane into the cell membrane takes place; close intermembranous contact does not exclude the penetration of the contents of mycoplasmas into the cell. Perhaps intracellular parasitization of mycoplasmas. Damage to epithelial cells due to mycoplasma use of cellular metabolites and cell membrane sterols, and also due to the action of mycoplasma metabolites: hydrogen peroxide (hemolytic factor M, pneumoniae) and superoxide radicals. One of the manifestations of the defeat of cells of the ciliated epithelium is the dysfunction of the cilia down to the ciliostasis, which leads to disruption of mucociliary transport.

Mycoplasmosis (mycoplasmal infection) - Causes and pathogenesis

Symptoms of mycoplasmosis

The incubation period lasts 1-4 weeks, an average of 3 weeks. Mycoplasmas can affect various organs and systems. Respiratory mycoplasmosis proceeds in two clinical forms:

• acute respiratory disease caused by M. Pneumoniae.
• pneumonia due to M. Pneumoniae;

M. Pneumoniae infection can be asymptomatic.

An acute or respiratory disease caused by M. Pneumoniae is characterized by a light or moderate course, a combination of catarrhal-respiratory syndrome, mainly in the form of catarrhal pharyngitis or rhinopharyngitis (less often with the spread of the process to the trachea and bronchi) with a mild intoxication syndrome.

Mycoplasmosis (mycoplasmal infection) - Symptoms

Diagnosis of mycoplasmosis

Clinical diagnosis of M. Pneumoniae infection suggests ORZ or pneumonia, in some cases and its possible etiology. The final etiologic diagnosis is possible with the use of specific laboratory methods.

Clinical signs of pneumonia of mycoplasmal etiology:

• subacute onset of respiratory syndrome (tracheobronchitis, nasopharyngitis, laryngitis);
• subfebrile body temperature;
• unproductive, painful cough;
• sputum smear;
• scanty auscultative data;
• extrapulmonary manifestations: cutaneous, articular (arthralgia), hematological, gastroenterological (diarrhea), neurological (headache) and others.

Mycoplasmosis (mycoplasmal infection) - Diagnosis

[9], [10], [11], [12], [13], [14], [15], [16]

Treatment of mycoplasma infection

ARI caused by M. Pneumoniae does not require etiotropic therapy.

Drugs of choice in outpatients with suspected primary atypical pneumonia (M. Pneumoniae, S. Pneumoniae) are macrolides. Preference is given to macrolides with improved pharmacokinetic properties (clarithromycin, roxithromycin, azithromycin, spiramycin).

Alternative drugs are respiratory fluoroquinolones (levofloxacin, moxifloxacin); possibly the use of doxycycline.

The duration of therapy is 14 days. Preparations are taken orally.

Mycoplasmosis (mycoplasmal infection) - Treatment