Structure, life cycle, symptoms of diseases caused by mycoplasma pneumonia

A dangerous inflammatory disease of the lungs caused by a pathogenic agent is mycoplasma pneumonia. Let's consider the peculiarities of the disease and the methods of its treatment.

Atypical damage to the mucous membrane and all elements of the structure of the respiratory system caused by the mycoplasma bacteria occurs in 10% of cases of all inflammations. The spread of the pathogenic microorganism occurs by airborne droplets. The infectious process formed under its influence is characterized by a prolonged course from 2-3 weeks to several months.

According to the International Classification of Diseases of the 10th revision of ICD-10, mycoplasma pneumonia is classified as X Diseases of the respiratory system (J00-J99):

J09-J18 Flu and pneumonia.

• J15 Bacterial pneumonia, not elsewhere classified.
  • J15.7 Pneumonia caused by Mycoplasma pneumoniae.

And also to category J20.0 Acute bronchitis caused by mycoplasma pneumoniae.

Anthroponous disease is accompanied by catarrhal and respiratory symptoms, pronounced intoxication, dyspepsia and other pathologies. This type of pneumonia manifests itself in the form of sporadic cases, and epidemic outbreaks. It has seasonal fluctuations with a peak in the autumn-winter period.

What is dangerous mycoplasma pneumonia?

Atypical form of pneumonia very often leads to severe consequences, worsening the work of the whole organism. Let's consider in more detail, what is dangerous mycoplasma pneumonia:

• Intoxication of the body with the products of the disintegration of pathogenic microorganisms.
• Dysfunction of lungs and oxygen exchange.
• Pathology of the cardiovascular system.
• Severe respiratory failure.
• Bronchial asthma.
• Fibrosis, lung abscess.
• Disorders from the central nervous system.

In addition to the above problems, the patient may encounter different severity of adverse reactions to medications used. With a properly formulated therapy plan, recovery and rehabilitation course take about 6 months.

Structure of the mycoplasma pneumonia

Mycoplasmas are microbes living in the epithelium of the tissues of the respiratory organs. The structure of this pathogenic microorganism is similar to chlamydia. Bacteria do not have strong cell membranes and the ability to create energy bonds. For their existence and reproduction, nutrients from the human body are needed.

This structure of bacteria has its advantages:

• Due to the small sizes of 0.3 to 0.8 μm, they easily penetrate into healthy cells of the lungs, trachea and bronchi.
• Fast move, so when the cell death in which parasitized, find a new one, destroying it.
• Hold tightly to the cell membranes, so pneumonia develops even with a small number of pathogens.
• After penetrating the mucous membranes of the respiratory organs, they rapidly increase their population and disrupt the work of the affected tissues.
• Not available for immune bodies and antibodies, as they are similar to some healthy cells in the body. Because of this, the causative agent may not cause an immune response of the affected organism for a long time.

In the structure of community-acquired pneumonia, respiratory mycoplasmosis occupies 5-50%. The disease has an intermediate position between bacteria, viruses, protozoa.

The main causes of pulmonary mycoplasmosis are the infection of Mycoplasma pneumoniae from a sick person. Normally this type of pathogenic microorganisms is contained in every healthy person, but under the influence of certain factors it is activated. Most often the disease occurs because of such reasons:

• Immunodeficiency conditions.
• Bad habits: smoking, alcoholism, drug addiction.
• Decompensated diabetes mellitus.
• Chronic obstructive pulmonary disease.
• Seasonal flu epidemics.
• Bronchitis.
• Local bronchial obstruction.
• Cystic fibrosis.
• Bronchiectasis.

Vysokovorulentnye strains of anaerobic bacteria are small, non-cell-walled organisms. Mycoplasma is absorbed by the cells of the bronchi and alveoli, parasitizing on their membranes. Because of their introduction, the body forms an autoimmune reaction with a number of painful symptoms.

In addition to pneumonia, bacteria can cause such diseases:

• Acute inflammation of the upper respiratory tract.
• Bronchial asthma.
• Exacerbation of chronic obstructive bronchitis.
• Various non-expiratory pathologies: otitis media, encephalitis, pericarditis, meningitis, hemolytic anemia.

Infectious agents are easily transmitted by airborne droplets from both infected with severe symptoms and asymptomatic carriers. Bacteria do not grow when the moisture content of the nutrient medium is inadequate, therefore, the occurrence of a runny nose and coughing with phlegm is provoked. They are not resistant to the environment, do not tolerate drying, heating and ultrasound. The main feature of infection is the periodic chronicization of the disease with the generalization of infection.

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

Life cycle of the mycoplasma pneumonia

Mycoplasmal infection of the respiratory tract is characterized by a gradual and gradual development. The life cycle of the bacterium is 12-14 days, but it can last for more than a month. During this period, the infected may not even suspect that he is sick.

Infection is characterized by a phased current:

• The tide lasts about 80 hours, is characterized by a sharp flow of blood into the lung tissue and exudation. Against this background, there is edema of the body and its inflammation.
• Red cure - lasts no more than 70 hours. Pulmonary tissues become denser and increase in volume. Exudate contains an increased concentration of erythrocytes.
• Gray cure - lasts about 5-7 days. Erythrocytes gradually disappear from the exudate and the level of leukocytes rises. Pulmonary tissues become gray in color.
• Resolution - takes 10-12 days. There is a resorption of fibrin and decay of leukocytes. The lungs are restored.

Under the defeat, the upper respiratory tract enters, provoking dryness and stuffiness of the nose, nasopharyngitis, laryngitis. The temperature rises and sweating increases, overall health worsens. Bacteria provoke a paroxysmal cough, which can last more than a month. During the cough there is a separation of thick, in some cases purulent sputum. Without proper treatment, mycoplasmas actively multiply, constantly repeating their life cycle, hitting the weakened organism and causing the progression of painful symptoms.

Risk factors

Atypical form of pneumonia has certain risk factors that contribute to its appearance. Predisposition to the disease is based on age criteria:

Patients of early childhood:

• Birth trauma.
• Malformations of the lungs and heart.
• Pneumopathy of the newborn.
• Intrauterine hypoxia.
• Asthma
• Cystic fibrosis.
• Gykopitaminosis.
• Hereditary immunodeficiencies.

Children of school age:

• Immunodeficiency conditions.
• Bronchitis.
• Chronic infectious lesions of the nasopharynx.
• Acquired vascular system defects.

Patients of adult age:

• Chronic lung diseases.
• Immunodeficiency conditions.
• Smoking.
• Bronchitis.
• Heart failure.
• Surgical operations of the abdominal cavity and chest.
• Diseases of the endocrine system.

Recent medical studies have established the relationship between dental pathology and bacterial pneumonia. People with problem teeth have 86% higher risks of developing respiratory mycoplasmosis.

[6], [7], [8], [9]

Pathogenesis

The mechanism of development of atypical pneumonia is associated with the infection of Mycoplasma pneumoniae. The pathogenesis of the disease state is based on the ingress of an infectious agent on the mucous membranes of the respiratory tract. Bacteria penetrate the mucociliary barrier, attaching to membranes of epithelial cells. Mycoplasmas are built into healthy cells, gradually destroying them.

There are several ways of penetration of pathogens into the parenchyma of the lung tissue:

• Bronchogenic - bacteria enter the body with inhaled air. The process of infection is significantly accelerated with inflammatory lesions of the nasal cavity. Swollen mucous membrane with inflamed cilia of the epithelium is unable to retain germs. Infectious focus can be caused by chronic processes in the pharynx, tonsils or lower parts of the respiratory tract. The emergence of the disease contributes to aspiration and various medical manipulations.
• Hematogenous - microbes enter the body with blood flow. Infection occurs when the septic state, intrauterine infection or intravenous drug use.
• Lymphogenous - bacteria enter the lymphatic system and are carried along the body with a current of lymph.

With the help of one of the above-described pathways, pathogenic microorganisms penetrate the body, settling on the tissues of the lungs and bronchioles. Because of this, not only pneumonia, but also bronchitis, bronchiolitis and a number of other diseases can develop.

In the pathogenesis of mycoplasmosis, immunopathological reactions are of great importance. Respiratory lesions are characterized by cold agglutinins. That is, mycoplasma pneumonia affects the antigens of erythrocytes I, turning them into immunogens. Because of this, cold IgM antibodies to the erythrocyte I antigen appear. Bacteria induce an immune response of the body, which is accompanied by the production of secretory IgA and circulating IgG antibodies.

How is mycoplasma pneumonia transmitted?

Inflammation of the lungs arises from a variety of causes. Faced with an atypical form of the disease, many patients wonder how the mycoplasma pneumonia is transmitted.

The main routes of infection are:

• Airborne - infection occurs when you are in contact with a sick person. When coughing or sneezing, pathogenic microorganisms enter a healthy body. Infection penetrates the mucous membranes of the nasal and oral cavity. For prevention, you should wear protective masks during the epidemiological period and adhere to the rules of personal hygiene.
• Airborne dust - mycoplasma bacteria can be found in rooms with poor ventilation and poor quality of cleaning.

To date, about 12 different forms of mycoplasmas have been identified, which were found in the nasopharynx and urinary tract. But in the human body can function only three types. Outbreaks of infection occur no more than once a year. The risk of infection increases significantly in densely populated cities. The disease is transmitted very slowly, indicating its viral nature.

[10], [11], [12], [13], [14], [15], [16], [17]

Epidemiology

About 10% of cases of inflammation of the lower respiratory tract occurs due to Mycoplasma pneumoniae. The disease is widespread among patients from 5 to 35 years and after 65.

Statistics of the disease state indicates its annual progression. At the same time, cases of infection of children of school age and of an earlier age have become more frequent. Epidemics caused by a bacterium occur in large cities with a frequency of 3-7 years. The risk of infection is associated not only with age characteristics, but also with the level of protective properties of the immune system.

[18], [19], [20], [21], [22]

Symptoms

Atypical form of inflammation caused by mycoplasmas develops in the upper respiratory tract with various pathological manifestations. Symptoms of the disease are conventionally divided into two groups:

Respiratory:

• Bronchitis.
• Tracheitis.
• Pleurisy.
• Abscesses of the lungs.
• Pharyngitis.

Not respiratory (arise due to damage to internal organs or body systems):

• Anemia.
• Hepatitis.
• Pancreatitis.
• Dermatological reactions.
• Myocarditis.
• Pericarditis.
• Thrombocytopenia.
• Polyartrit.
• Arthralgia.

The disease has a subacute onset of respiratory syndrome. Gradually appears subfebrile body temperature, unproductive and painful coughing, spitting out of sputum character. There are also various extrapulmonary symptoms of infection.

The rapid growth of painful symptoms is due to the fact that pathogens are not very influenced by the human immune system. In addition, bacteria are insensitive to most antibacterial drugs.

First signs

The causative agent of anthroponic infectious disease occupies an intermediate position between bacteria and viruses. This is due to the fact that mycoplasma parasitizes on the cellular membranes of the ciliary epithelium of the bronchi and can penetrate inside the cells.

Infection usually occurs by airborne droplets, which resembles ARVI or influenza, but with a slower spread. The incubation period is 2-3 weeks, after which the first signs of mycoplasma pneumonia appear:

• Deterioration of general well-being and increased weakness.
• Subfebrile body temperature.
• Pershing and dryness in the throat, hoarse voice.
• Headache.
• Redness of soft palate and pharynx.
• Dry paroxysmal cough.
• Pain in the ears and eyes.
• Muscle pain.
• Increased sweating.
• Soreness of the joints.
• Dyspnea.
• Increase and soreness of the cervical lymph nodes.

In addition to respiratory symptoms, the disease is characterized by other symptoms: lesions of the gastrointestinal tract, dermatological rashes, various neurological symptoms. At carrying out of laboratory researches the raised values of an ESR and absence of a leukocytosis are observed.

The above symptoms increase for 5-7 days. Thus the patient is dangerous to associates within 20 days. During the examination, the doctor reveals finely bubbling rales, shortening the sound of percussion, which is the reason for conducting laboratory diagnostics and radiography.

[23], [24], [25]

Mycoplasma pneumonia in adults

A fairly common disease diagnosed in the autumn-winter period is mycoplasma pneumonia. In adults, this pathology is less common than in children and as a rule is combined with parainfluenza.

Mycoplasmas are microorganisms without cell walls. By their size, they are close to viruses, and by morphology to L-forms of bacteria. The mucous membrane of the respiratory tract is affected, provoking its pathological changes. At first, there is a rather nonspecific symptomatology:

• Pain in the throat.
• Febrile state.
• Subfebrile body temperature.
• Headache.
• Pain in the eye sockets.
• Coryza.
• A dry, anguished cough.
• Chills.

Such signs very often lead to erroneous diagnosis and therapy of bacterial pneumonia. Symptoms typical for the disease arise as it progresses, that is, at its later stages. Because of this, there are various complications, both pulmonary and extrapulmonary.

Diagnosis of pathology consists of a complex of different examinations. When performing X-ray, there is an increase in the pulmonary pattern and shallow focal shadows in the lower parts of one or both lungs. To confirm the diagnosis, a blood test for Ig to Mycoplasma pneumoniae M, A, G is shown. Adult treatment consists of antibacterial therapy, vitamin therapy and physiotherapy. Recovery is long and requires an integrated approach.

Mycoplasma pneumonia in pregnancy

Any diseases that arise during the carrying out of a child are dangerous for both the mother and the future baby. Mycoplasma pneumonia during pregnancy is dangerous not only for its complications, but also for a hidden / lubricated course similar to the symptoms of a cold. Because of this, many women do not seek timely medical help, trying to eliminate the disorder themselves. This behavior only complicates pathology and its prognosis.

Home treatment very often leads to the attachment of secondary infection and suppurative complications. Pulmonary mycoplasmosis during pregnancy is dangerous by the development of respiratory failure, myocarditis, endocarditis, septic states, exudative pleurisy, edema and lung abscess. If an atypical form of pneumonia was detected on time, then the prognosis is favorable.

Mycoplasma pneumonia in children

In the complex of respiratory diseases special attention deserves mycoplasma pneumonia in children. This is due to the fact that it is the patients of young age that are more prone to infection, and the disease has pronounced symptoms. Most often the development of inflammation occurs against the background of acute lesions of the respiratory tract: bronchitis, tonsillitis, tracheobronchitis and others.

Mycoplasma pneumoniae infection in children is manifested by such basic syndromes:

1. Intoxicating

Because inflammation of the lung tissue affects small areas, it is rarely accompanied by severe symptoms of intoxication. If several lung segments or whole lobes are involved in the pathological process, the intoxication symptoms come to the fore. In children, there is such symptomatology:

• Increased body temperature.
• Chills and febrile condition.
• Rapid pulse.
• Fast fatiguability.
• Pale skin.
• Increased drowsiness.
• Disorders of appetite and refusal to eat.
• Increased sweating.
• Nausea and vomiting.

The duration of the above symptoms is 3-4 days. If during this time treatment has not been started, then the morbid condition progresses.

2. Inflammation of lung tissue

The appearance of such signs allows one to suspect the bacterial nature of lung injury. The main symptoms of a specific inflammation are:

• Dry cough.
• Poor sputum discharge.
• Painful sensations behind the sternum and in the throat.
• Auscultative changes.
• X-ray signs.
• Violations of the norms of hemoly leucograms.

Features of an infectious cough consist in its constant presence, regardless of time of day. It has a paroxysmal nature and occurs when trying to take a deep breath. Against this background, sputum-purulent sputum is possible. There are aching pains in the abdomen and chest, which intensify with deep breathing.

3. Respiratory failure

Because of the defeat of lung tissue, the area of the so-called breathing organ surface decreases, respiratory failure occurs. In this case, the younger the child, the brighter the pathological symptoms:

• Increases respiratory movements.
• Difficult breath.
• Cyanosis of the nasolabial triangle.
• Mobility of the wings of the nose during breathing.

Dyspnea appears from the first days of the disease. Difficult, irregular breathing causes great anxiety both in children and parents, leading to sleep disturbances. During breathing, there is a retraction of the skin in the supraclavicular and subcostal area, the spaces between the ribs. Without timely and proper treatment, painful symptoms quickly increase.

Bronchiolitis and mycoplasma pneumonia

Inflammatory disease affecting small bronchi is bronchiolitis. Mycoplasma pneumonia can be one of the causes of a painful condition. Inflammation of bronchioles often occurs due to such factors:

• Infection of the respiratory system with bacterial or viral agents.
• Inhalation of toxic substances for a long period of time.
• Rheumatoid arthritis.
• Diseases with affection of connective tissue in the anamnesis.

Depending on the severity of the pathological process, bronchiolitis has this classification:

1. Acute - the symptoms develop rapidly. The patient's condition deteriorates rapidly, signs of intoxication appear.
2. Chronic - signs of this form appear gradually. At first, the disease state is not noticeable, but it becomes brighter every year.

Bronchiolitis caused by Mycoplasma pneumoniae refers to the obliterating form of the disease. Symptoms of the disorder are manifold, but the most pronounced is shortness of breath. As the pathology progresses, cyanosis of the skin appears, obstructive paroxysmal cough, subfebrile body temperature, edema of the upper limbs.

Diagnosis of the infectious process can present certain difficulties. The standard research algorithm consists of: chest radiography, spirography, CT, bronchoscopy and others.

Treatment consists of taking antiviral, antibacterial and anti-inflammatory drugs. To reduce dyspnea and bronchial dilatation, bronchodilators and mucolytics are prescribed to accelerate sputum discharge. If the disease is severe, oxygen inhalations are indicated. Particular attention is paid to preventive measures, which consist of strengthening the protective properties of the immune system.

[26], [27], [28], [29], [30], [31], [32], [33]

Atypical pneumonia

Infectious-inflammatory lung lesions caused by uncharacteristic pathogens are atypical pneumonia. Most often, the disease occurs because of such reasons:

• Mycoplasma.
• Chlamydia.
• Influenza viruses A, B.
• Respiratory viruses of parainfluenza.
• Koksiella.
• Legionella.
• Epstein-Barra virus and other pathogens.

The above pathogens have different microbiological features, so the diseases differ in epidemiology and pathomorphology. To date, there are such forms of atypical pneumonia: mycoplasmal, chlamydia, ku-fever, legionnaires' disease.

Like most infectious pathologies, the atypical form has such stages:

1. Incubation - lasts 7-10 days from the time of infection.
2. Prodromal - 1-3 days with the appearance of nonspecific symptoms of respiratory viral infections (headaches and muscle pains, dry cough, swelling in the throat).
3. The height is a pronounced infection-inflammatory process in the lungs.
4. Reconvalescence - the activity of the painful condition gradually subsides and the patient's condition is normalized.

Allocate such general symptoms, characteristic for all types of atypical pneumonia:

• Increased weakness.
• Cough and shortness of breath.
• Abundant sweating.
• Elevated body temperature up to 40-41 ° C.
• Pain in the chest.

In addition to the above signs, the mycoplasma form often occurs with an increase in the liver and spleen. Diagnosis is based on the clinical picture of the disorder. Patients undergo lung radiography in two projections to determine the focus of inflammation. To identify the pathogen shows bacteriological, microbiological and immunological studies.

Treatment of atypical pneumonia consists of etiotropic and symptomatic therapy. It is necessary to destroy pathogenic microorganisms and to conduct concomitant treatment. Without proper and timely treatment, the disease causes a number of complications that substantially worsen the functioning of the whole organism.

[34], [35], [36], [37], [38], [39], [40]

Complications and consequences

Mycoplasmal pneumonia is a serious disease with rather serious consequences and complications. Proceeding from this, these pathological conditions are distinguished:

• Pulmonary (affect bronchi, pleura and of course pulmonary tissue).
  • Pleurisy is an inflammation of the pleura that covers the lungs. Can occur both in dry and wet form. In the first case, clots of fibrin accumulate in the pleural cavity, which glue the tissues together. The main sign of this complication is the growing symptoms of respiratory failure and pain behind the sternum.
  • Empyema is a purulent form of pleurisy, in which pus accumulates in the pleural cavity. The symptomatology is similar to the exudative form of the disease. The main sign of pathology is a very high body temperature and febrile state.
  • Abscess of the lung - one or more cavities in which the purulent contents accumulate form in the organ. The destructive process is characterized by the destruction of lung tissue and severe intoxication. At the initial stage the abscess is closed, but gradually breaks through into the pleural cavity or bronchi. The patient has abundant sputum, body temperature decreases. If the abscess breaks through the pleura, then this leads to its empyema.
  • Obstructive syndrome - shortness of breath and frequent attacks of suffocation. Pulmonary tissues lose their functionality and connective tissue is formed in their place.
  • Lung edema is the most dangerous complication of bacterial pneumonia. The fluid from the vessels enters the lungs and alveoli, filling them. Against the background of increased excitation, the patient suffocates. There is a strong cough, the skin is cold and sticky. Without a timely resuscitation, a lethal outcome is possible.
• Extrapulmonary (due to the action of bacteria that exert a destructive effect on internal organs and body systems).
  • Toxic shock - the toxins released by bacteria and viruses penetrate into the blood. Against this background, multi-organ failure is increasing. At least three body systems are involved in the pathological process: digestive, cardiovascular and renal. A painful condition is accompanied by fever, polymorphous eruptions on the body and a sharp decrease in blood pressure.
  • Cardiac complications - myocardial dysfunction is caused by hemolytic anemia, which in its symptoms resembles myocardial infarction. It is also possible the development of pericarditis, myocarditis, hemopericardium, AV blockade, severe cardiac insufficiency.
  • Meningitis is an inflammatory lesion of the meningeal membranes of the brain. It develops due to the penetration of harmful microorganisms into the central nervous system. It causes attacks of nausea and vomiting, rigidity of the occipital muscles and photophobia.
  • Hepatitis is a fairly common complication of SARS. The pulmonary tissues are damaged because of what the liver does not cope with the functions. The products of disintegration and exchange of pathogenic microorganisms are not excreted from the body, but accumulate in it. This leads to an increase in the level of bilirubin and jaundice. Patients complain of nausea and vomiting, pain in the right upper quadrant.
  • Lesions of the nervous system - meningoencephalitis, serous meningitis, ascending paralysis, myelitis, encephalitis. Such complications complicate the process of recovery.
  • Lesion of the skin and mucous membranes - most often in patients diagnose spotted-papular and vesicular rash, aphthae, conjunctivitis.
  • Articular pathology - arthritis and rheumatic attacks.

In addition to the above complications, mycoplasma pneumonia causes a variety of severity dyspeptic disorders. The frequency of deaths from the effects of pneumonia is 3-5%, in the presence of chronic diseases can reach 30%.

[41], [42], [43], [44], [45]

Prevention of the mycoplasma pneumonia

Specific methods of preventing atypical pneumonia are not developed. Prophylaxis is aimed at increasing the protective forces of the immune system and reducing the risk of complications.

Basic methods of prevention:

• Immunization, that is, hardening and vitamin therapy. Such methods stimulate the immune system.
• Timely treatment of any diseases, especially seasonal colds.
• Avoiding hypothermia and stress, balanced nutrition.

Also, possible contacts with infected mycoplasma infection should be eliminated. If you follow preventive measures and promptly seek medical help, the risk of developing a severe form of the disease is minimal.

[46], [47], [48], [49], [50]

Forecast

With atypical pneumonia, the prognosis of the disease depends on such factors:

• Age of the patient.
• Virulence of a pathogenic microorganism.
• Presence of chronic diseases.
• Protective properties of the immune system.
• Timeliness and reliability of the performed diagnostics.
• Adequacy of prescribed therapy.

An unfavorable prognosis with the development of complications is typical for patients with immunodeficient conditions and with pronounced resistance of pathogens to antibacterial therapy. Particular danger is the disease in patients of childhood. In this group of patients, the risk of a lethal outcome is 10-30%.

With timely and correct therapy, the illness ends with recovery. There are such changes in the lung tissue after the transferred pathology:

• Complete restoration of tissues and organ structure - 70%.
• Local pneumosclerosis is 25-30%.
• Focal carnification - 10%.
• Decrease in the proportion or segment of the lung in size - 2-5%.
• The wrinkling of the lungs and the development of the infectious process - less than 1% of cases.

Mycoplasma pneumonia has rare cases of death, but it is characterized by a high risk of severe consequences.

[51], [52], [53]