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Mycoplasmosis (mycoplasmal infection)
Last reviewed: 12.07.2025
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Mycoplasmosis (mycoplasma infection) is an anthropozoonotic infectious disease caused by bacteria of the genera Mycoplasma and Ureaplasma, characterized by damage to various organs and systems (respiratory organs, genitourinary, nervous and other systems).
A distinction is made between:
- Respiratory mycoplasmosis (mycoplasma-pneumonia infection);
- Urogenital mycoplasmosis (non-gonococcal urethritis, ureaplasmosis and other forms) is discussed in the national guide to dermatovenereology.
ICD-10 codes
- J15.7. Pneumonia due to Mycoplasma pneumoniae.
- J20.0. Acute bronchitis due to Mycoplasma pneumoniae.
- B96.0. Mycoplasma pneumoniae (M. pneumoniae) as the cause of diseases classified to other chapters.
Epidemiology
The source of the pathogen is a sick person with a manifest or asymptomatic form of M. pneumoniae infection (it can be isolated from pharyngeal mucus for 8 weeks or more from the onset of the disease, even in the presence of antimycoplasma antibodies and despite effective antimicrobial therapy). Transient carriage of M. pneumoniae is possible.
The transmission mechanism is aspirational, carried out mainly by airborne droplets. For the transmission of the pathogen, fairly close and prolonged contact is necessary.
Causes of mycoplasmosis
Mycoplasmas are bacteria of the Mollicutes class: the causative agent of respiratory mycoplasmosis is mycoplasma of the Pneumoniae species of the Mycoplasma genus. The absence of a cell wall determines a number of properties of mycoplasmas, including pronounced polymorphism (round, oval, filiform shapes) and resistance to beta-lactam antibiotics. Mycoplasmas reproduce by binary fission or as a result of desynchronization of cell division and DNA replication, they elongate with the formation of filiform, mycelial forms containing a repeatedly replicated genome and subsequently dividing into coccoid (elementary) bodies.
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Pathogenesis of mycoplasma infection
M. pneumoniae gets on the surface of the mucous membranes of the respiratory tract. It penetrates the mucociliary barrier and firmly attaches to the membrane of epithelial cells using terminal structures. Parts of the pathogen membrane are embedded in the cell membrane; close intermembrane contact does not exclude the penetration of mycoplasma contents into the cell. Intracellular parasitism of mycoplasmas is possible. Damage to epithelial cells due to the use of cellular metabolites and sterols of the cell membrane by mycoplasmas, as well as due to the action of mycoplasma metabolites: hydrogen peroxide (hemolytic factor M, pneumoniae) and superoxide radicals. One of the manifestations of damage to the cells of the ciliated epithelium is dysfunction of the cilia up to ciliostasis, which leads to disruption of mucociliary transport.
Mycoplasmosis (Mycoplasma Infection) - Causes and Pathogenesis
Symptoms of mycoplasmosis
The incubation period lasts 1-4 weeks, on average 3 weeks. Mycoplasmas are capable of affecting various organs and systems. Respiratory mycoplasmosis occurs in two clinical forms:
- acute respiratory disease caused by M. pneumoniae.
- pneumonia caused by M. pneumoniae;
M. pneumoniae infection may be asymptomatic.
Acute respiratory disease caused by M. pneumoniae is characterized by a mild or moderate course, a combination of catarrhal-respiratory syndrome, mainly in the form of catarrhal pharyngitis or nasopharyngitis (less often with the spread of the process to the trachea and bronchi) with a mild intoxication syndrome.
Diagnosis of mycoplasmosis
Clinical diagnosis of M. pneumoniae infection allows us to assume acute respiratory disease or pneumonia, and in some cases its possible etiology. Final etiological diagnosis is possible using specific laboratory methods.
Clinical signs of pneumonia of mycoplasmal etiology:
- subacute onset of respiratory syndrome (tracheobronchitis, nasopharyngitis, laryngitis);
- subfebrile body temperature;
- unproductive, painful cough;
- non-purulent nature of sputum;
- scanty auscultatory data;
- extrapulmonary manifestations: cutaneous, joint (arthralgia), hematological, gastroenterological (diarrhea), neurological (headache) and others.
Mycoplasmosis (mycoplasma infection) - Diagnosis
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Treatment of mycoplasma infection
ARI caused by M. pneumoniae does not require etiotropic therapy.
The drugs of choice for outpatients with suspected primary atypical pneumonia (M. pneumoniae, C. pneumoniae) are macrolides. Preference is given to macrolides with improved pharmacokinetic properties (clarithromycin, roxithromycin, azithromycin, spiramycin).
Alternative drugs - respiratory fluoroquinolones (levofloxacin, moxifloxacin); doxycycline may be used.
The duration of therapy is 14 days. The drugs are taken orally.