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Mycoplasma pneumoniae is one of the most common causes of community acquired pneumonia, particularly in young adults. Vital signs are usually normal except for temperature. On physical examination, general appearance is normal compared with that of typical pneumonia such as pneumococcal pneumonia patients. Mycoplasma sometimes causes ear infections...
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Mycoplasma pneumoniae infections mainly involve respiratory tract; however, also can manifestate other symptoms by site involved. Extrapulmonary manifestations of M. pneumoniae infection are rarely known to occur without pneumonia. Herein we report a case of a 9-year-old boy who presented with acute cholestatic hepatitis in the absence of pneumonia...
Citations
... The commensal bacteria that are typically found in the respiratory tract of healthy populations make up the majority of the sputum microbiota in most patients, suggesting potential resistance or resilience of the respiratory microbiota against acute infection. Meanwhile, a sizeable proportion of samples (14.0%) had microbiota with unusually high abundances of possible pathogens, including Enterobacteriaceae, Pseudomonas, Acinetobacter, Mycoplasma, and Stenotrophomonas, all previously proposed as pneumonia-causing pathogens [19,[31][32][33][34], suggesting abnormal pathogen growth. In addition, 10.3% of samples had a microbiota predominated by non-typical pathogenic bacteria, such as Corynebacterium, Rothia, and Haemophilus, highlighting the complexity of the CAP microbiota (Fig. S2I). ...
Background
Community-acquired pneumonia (CAP) is a common and serious condition that can be caused by a variety of pathogens. However, much remains unknown about how these pathogens interact with the lower respiratory commensals, and whether any correlation exists between the dysbiosis of the lower respiratory microbiota and disease severity and prognosis.
Methods
We conducted a retrospective cohort study to investigate the composition and dynamics of sputum microbiota in patients diagnosed with CAP. In total, 917 sputum specimens were collected consecutively from 350 CAP inpatients enrolled in six hospitals following admission. The V3-V4 region of the 16 S rRNA gene was then sequenced.
Results
The sputum microbiota in 71% of the samples were predominately composed of respiratory commensals. Conversely, 15% of the samples demonstrated dominance by five opportunistic pathogens. Additionally, 5% of the samples exhibited sterility, resembling the composition of negative controls. Compared to non-severe CAP patients, severe cases exhibited a more disrupted sputum microbiota, characterized by the highly dominant presence of potential pathogens, greater deviation from a healthy state, more significant alterations during hospitalization, and sparser bacterial interactions. The sputum microbiota on admission demonstrated a moderate prediction of disease severity (AUC = 0.74). Furthermore, different pathogenic infections were associated with specific microbiota alterations. Acinetobacter and Pseudomonas were more abundant in influenza A infections, with Acinetobacter was also enriched in Klebsiella pneumoniae infections.
Conclusion
Collectively, our study demonstrated that pneumonia may not consistently correlate with severe dysbiosis of the respiratory microbiota. Instead, the degree of microbiota dysbiosis was correlated with disease severity in CAP patients.
... Mycoplasma pneumoniae is a common pathogen causing community acquired pneumonia in children. Although MP infection is asymptomatic and self-limited in most cases, it may present with extrapulmonary manifestations in severe cases, in which the CNS is a common site of involvement, with the prevalence ranging from 1.0% to 4.8% [5]. Cerebral infarction is a rare and severe neurological manifestation of M pneumoniae infection and only a few cases have been reported. ...
Mycoplasma pneumoniae (MP) is one of the most common respiratory pathogens causing respiratory infection in children, especially in those above 5 years old. Although rare, cerebral infarction is the most severe neurological complication of MP infection and could be fatal. Herein, we report a case of extensive and progressive acute cerebral infarction associated with MP infection, which not only received medical treatment but also underwent a decompressive craniectomy. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) revealed occlusion of the left internal carotid artery, left anterior cerebral artery, and middle cerebral artery. In order to better understand the relationships between MP infection and cerebral infarction both on clinical and radiological perspectives, literature of cerebral infarction associated with MP infection were searched and reviewed.
... Although MP infection is asymptomatic and selflimited in most cases, it may present with extrapulmonary manifestations in severe cases, in which the CNS is a common site of involvement, with the prevalence ranging from 1.0-4.8% [5]. Cerebral infarction is a rare and severe neurological manifestation of M pneumoniae infection and only a few cases have been reported. ...
Backgrounds
Mycoplasma pneumoniae (MP) is one of the most common respiratory pathogens causing respiratory infection in children, especially in those above 5 years old. Although rare, cerebral infarction is the most severe neurological complication of MP infection and could be fatal.
Case presentation
Here, we report a case of extensive and progressive acute cerebral infarction associated with MP infection, which not only received medical treatment but also underwent a decompressive craniectomy. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) revealed occlusion of the left internal carotid artery, left anterior cerebral artery, and middle cerebral artery. In order to better understand the relationships between MP infection and cerebral infarction both on clinical and radiological perspectives, literature of cerebral infarction associated with MP infection were searched and reviewed.
Conclusions
Cerebral infarction is a rare complication of MP infection, which can result in neurological sequelae or even death. Clinicians should pay attention to neurological signs or symptoms after MP infection. CT or MR even CTA or MRA should be considered to make timely assessment and diagnosis, especially in severe and refractory cases.
... Деякі автори рекомендують застосовувати його як допоміжний метод діагностики під час первинного скринінгу пацієнтів із підозрою на вірусну пневмонію [13], потім діагноз слід підтвердити позитивним результатом тесту полімеразної ланцюгової реакції (ПЛР) на наявність етіологічного чинника, який спричинив ураження легень [8]. Варто уваги те, що саме така послідовність виконання діагностичних методів рекомендована ще у 2020 р., адже вже тоді було показано, що ПЛР-тест має багато обмежень: 1) при низькому вірусному навантаженні рівень ідентифікації збудника низький, що може призвести до хибнонегативного результату; 2) при позитивному результаті ПЛР-тесту можна підтвердити діагноз COVID-19, але неможливо визначити тяжкість ураження дихальної системи й особливості прогресування хвороби (тоді як за даними КТ ОГП можна встановити особливості й поширеність ураження легень, виявити ознаки прогресування пневмонії/ пневмоніту, візуалізувати ускладнення, провести диференціальну діагностику з іншими, зокрема невірусними, патологічними процесами в легенях [9,12] тощо); ...
Objective — to determine the imaging changes in community-acquired pneumonia in different severity of COVID-19; to define the diagnostic significance of CT, LUS, establish the correspondence of CT- and LUS-patterns. Materials and methods. We examined 22 patients (pts) (men — 11 (50.0 %), women — 11 (50.0 %), mean age — 67.0 (54.0; 74.0) years) with COVID-19 pneumonia. Clinical examination — general investigation, assessment of dyspnea severity (mMRC), pulse oximetry. The spread of lung lesions was determined by CT and LUS. Changes were described as CT- and LUS-patterns. Non-parametric. Results and discussion. In severe COVID-19 cases (end of the 1st week of illness), the extent of lung lesions aligned with CT-1, revealing bilateral subpleural «ground glass» opacities. Bilateral changes were observed in lung ultrasound (LUS), with a Lung Ultrasound Score (LUSS) of 2—4 points. The CT pattern of «ground glass» corresponded to LUS patterns indicating mild to moderate interstitial changes (IC).By the 2nd and 3rd weeks, the area of lung lesions corresponded to CT-1 and 2, and the CT pattern of «ground glass» became diffuse and bilateral. Bilateral LUS changes were noted, with LUSS ranging from 4 to 18 points. The CT pattern of «ground glass» aligned with LUS patterns indicating mild to moderate IC, pleural thickening, and the absence of A-lines. The CT pattern of consolidation corresponded to a similar LUS pattern.In patients with a critical course during the 2nd and 3rd weeks, the lesion area extended to 60–90 %. Bilateral LUS changes persisted, with LUSS ranging from 16 to 22 points. There was a significant correlation between the area of lung lesions observed on CT and LUS (p < 0.0001). Conclusions. In the 1st week of illness, verification of severe COVID-19 should be grounded in the presence of severe dyspnea and decreased saturation. During the 2nd and 3rd weeks, verification can be based on decreased saturation and the extent of lung lesions as assessed by CT and lung ultrasound (LUS). In critical patients, the area of lung lesions ranged from 60 to 90 % on CT and/or exceeded 15 points on the LUSS. The CT pattern of «ground glass» corresponded to interstitial changes (IC), pleural thickening, and the absence of A-lines on LUS. Similarly, the CT pattern of consolidation corresponded to a consolidation pattern on LUS.
... M. pneumoniae infection is more prevalent in children and adults globally [1,2,4]. The infection accounts for 20-30 % of community-acquired pneumonia in adults and about 40 % in children >5 years old [5,6]. This gram-negative pleomorphic bacterium has the ability to penetrate the host cell membrane and cause direct damage to the host cells [7]. ...
... Community-acquired pneumonia (CAP) is a prevalent respiratory infection that can be caused by a variety of atypical bacterial microorganisms [43]. M. pneumoniae is one of the leading causes of such infections, accounting for approximately 7-20% of CAP cases [5]. Even though M. pneumoniae infections are typically mild, they can cause severe and potentially fatal pneumonia that spreads within communities and families [44]. ...
... To accelerate ligand-based virtual screening, compounds were chosen for molecular docking from each drug based on their electroshape scores. From the 30 molecules that were docked, 2-[(2R,4aS,12aS)-8-[[[(3,5-dimethyl-4-isoxazolyl)amino]-oxomethyl]amino]-5-methyl-6-oxo-2,3,4,4a,12,12a-hexahydropyrano[2,3-c] [1,5]benzoxazocin-2-yl]-N-[(3S)-1-(phenylmethyl)-3-pyrrolidinyl]acetamide (CHEBI97093) had the highest binding affinity of − 11.2 kcal/mol, which was higher than the control Rifabutin. Additionally, the analysis of the ligand-receptor complex revealed that the analog formed more conventional hydrogen bonds and did not have any unfavorable interactions with the receptors indicating its potential for further exploration. ...
Mycoplasma pneumoniae is a significant causative agent of community-acquired pneumonia, causing acute inflammation in the upper and lower respiratory tract as well as extrapulmonary syndromes. In particular, the elderly and infants are at greater risk of developing severe, life-threatening pneumonia caused by M. pneumoniae. Yet, the global increase in antimicrobial resistance against antibiotics for the treatment of M. pneumoniae infection highlights the urgent need to explore novel drug targets. To this end, bioinformatics approaches, such as subtractive genomics, can be employed to identify specific metabolic pathways and essential proteins unique to the pathogen that could be potential targets for new drugs. In this study, we implemented a subtractive genomics approach to identify 61 metabolic pathways and 42 essential proteins that are unique to M. pneumoniae. A subsequent screening in the DrugBank database revealed three druggable proteins with similarity to FDA-approved small-molecule drugs, and finally, the compound CHEBI:97093 was identified as a promising novel putative drug target. These findings can provide crucial insights for the development of highly effective drugs that selectively inhibit the pathogen-specific metabolic pathways, leading to better management and treatment of M. pneumoniae infections.
... Health Organization (WHO), chest radiography and CT were considered as useful diagnostic tools for the diagnosis of SARS when prevalent [56]. Although the former is not able to rule out COVID-19, it helps to gather medical evidence in favour of or against a particular disorder [57]. ...
Although a long time has passed since its outbreak, there is currently no specific treatment for COVID-19, and it seems that the most appropriate strategy to combat this pandemic is to identify and isolate infected individuals. Various clinical diagnosis methods such as molecular techniques, serologic assays, and imaging techniques have been developed to identify suspected patients. Although reverse transcription-quantitative PCR (RT-qPCR) has emerged as a reference standard method for diagnosis of SARS-CoV-2, the high rate of false-negative results and limited supplies to meet current demand are the main shortcoming of this technique. Based on a comprehensive literature review, imaging techniques, particularly computed tomography (CT), show an acceptable level of sensitivity in the diagnosis and follow-up of COVID-19. Indeed, because lung infection or pneumonia is a common complication of COVID-19, the chest CT scan can be an alternative testing method in the early diagnosis and treatment assessment of the disease. In this review, we summarize all the currently available frontline diagnostic tools for the detection of SARS-CoV-2-infected individuals and highlight the value of chest CT scan in the diagnosis, prognosis, staging, management, and follow-up of infected patients.
... All serum samples were applied to the cytokine detection kit (Bio-Plex Pro ™ Human Inflammation Panel 1, 37-Plex, Bio-Rad) for the levels of cytokines. The experiment and adjustment of instrument were conducted following manufacturer instructions (28); the results were obtained by Milliplex Analyzer (Luminex 200) (Table S1). Both the samples, quality controls and standards, were detected in two duplicates. ...
Mycoplasma pneumoniae (MP) is an important human pathogen that mainly affects children causing general and severe Mycoplasma pneumoniae pneumonia (G/SMPP). In the present study, a comprehensive immune response data (33 cytokines) was obtained in school-age children (3–9 years old) during MPP, aiming to analyze the immune response patterns during MPP. At acute phase, changes of cytokines were both detected in GMPP (24/33) and SMPP (23/33) groups compared to the healthy group (p < 0.05), with 20 identical cytokines. Between MPP groups, the levels of 13 cytokines (IL-2, IL-10, IL-11, IL-12, IL-20, IL-28A, IL-32, IL-35, IFN-α2, IFN-γ, IFN-β, BAFF, and TSLP) were higher and three cytokines (LIGHT, OPN and CHI3L1) were lower in the SMPP group than in the GMPP group (p < 0.05). Function analysis reveals that macrophage function (sCD163, CHI3L1) are not activated in both MPP groups; difference in regulatory patterns of T cells (IL26, IL27, OPN, LIGHT) and defective activation of B cells (BAFF) were detected in the SMPP group compared to the GMPP group. Besides, the level of osteocalcin; sIL-6Rβ and MMP-2 are both decreased in MPP groups at acute and convalescent phases compared to the healthy group, among which the levels of sIL-6Rβ and MMP-2 showed negative correlations (p < 0.1) to the application of bronchial lavage in SMPP group, indicating their roles in the development of MPP. At the convalescent phase, more cytokines recovered in GMPP (18) than SMPP (11), revealing better controlled immune response during GMPP. These results reveal different immune response patterns during GMPP and SMPP. In addition, the differentiated cytokines may serve as potential indicators of SMPP; early intervention on immune response regulations may be helpful in reducing the severity of SMPP.
... This is a popular respiratory pathogen that causes diseases of different acuteness reaching from mild to acute atypical pneumonia (6). This microorganism is also in charge of causing a broad spectrum of nonpulmonary disorders, like neurological, hepatic, cardiac diseases, hemolytic anemia, arthritis and erythema multiform (7). ...
Bacterial co-pathogens are commonly identified in viral respiratory tract infections. Co-infections with other pulmonary pathogens arisen in COVID-19 patients with the patient population evaluated had laboratory-confirmed corona virus infection. All extracted nucleic acid of nasopharyngeal swabs and sputum specimens which positive for COVID-19 diagnostic assays were submitted to morphological, cultural, biochemical and comparison the results with molecular test (Real time PCR technique) for detection of association of Streptococcus pneumoniae and Mycoplasma pneumoniae with COVID-19 patients. Cultural analysis showed S. pneumoniae and M. pneumoniae infection revealed an incidence of 20% and 10% percentage, respectively from 100 patients, while the molecular test were 33%, 13% respectively. Also, the strength of the correlation between age, sex, symptoms vaccinated and unvaccinated patients and its outcomes. From 100 positive COVID-19, medium patient's age was 55 years, 42% were women, and 58% were male. Cough was the most common submitting a complainant to all age bands (20-39, 40-59,60-79, and +80) 10%, 43%, 43%, and 4%, respectively (p<0.001). Diagnostic tests for known lung pathogens have limits. It was concluded that, despite positive cultural and biochemical not for all typical and atypical pathogens, in an environment where clinical suspiciousness for Corona virus is rise, specific analyses are being conducted for it. So, we are being performed RT-PCR to confirm a diagnosis. The most widespread signs are more presented in the older patients, and more infected with bacterial microorganism S. pneumoniae followed with M. pneumoniae, and with unvaccinated patients higher than vaccinated patients with 87%.
... In our case, at first, the patient was misdiagnosed with atypical pneumonia. Clinical manifestations of atypical pneumonia are non-specific [3], and chest CT findings of atypical pneumonia include a differential diagnosis such as PCP [8]. In an outpatient setting, rapid antigen detection assays are used for diagnosis of atypical pneumonia; however, these tests have a lower diagnostic sensitivity than genetic diagnostic methods such as PCR [9]. ...
We report a case of pneumocystis pneumonia (PCP) that mimicked atypical pneumonia in a patient with human immunodeficiency virus (HIV) infection. A 44-year-old Japanese man with persistent fever and dyspnea for a month was diagnosed with atypical pneumonia because of bilateral ground-glass opacities on chest computed tomography (CT). Ground-glass opacities on chest CT diminished with three days treatment of azithromycin; however, his symptoms were persistent. Final diagnosis of HIV and PCP infection was eventually confirmed. Physicians should consider the possibility of PCP even when pulmonary manifestations resolve with azithromycin in patients with HIV infection.
... However, the diagnostic challenge of childhood CAP is that although clinical symptoms and inflammatory markers and radiological signs are indicative of pathogens [12][13][14], pneumonia pathogens cannot be reliably distinguished [3,5,[15][16][17][18]. Sputum culture, multiplex polymerase chain reaction, or specific mycoplasma antibody tests can diagnose pneumonia [19,20] but have some limitations. ...
Clinical symptoms and inflammatory markers cannot reliably distinguish the etiology of CAP, and chest radiographs have abundant information related with CAP. Hence, we developed a context-fusion convolution neural network (CNN) to explore the application of chest radiographs to distinguish the etiology of CAP in children. This retrospective study included 1769 cases of pediatric pneumonia (viral pneumonia, n = 487; bacterial pneumonia, n = 496; and mycoplasma pneumonia, n = 786). The chest radiographs of the first examination, C-reactive protein (CRP), and white blood cell (WBC) were collected for analysis. All patients were stochastically divided into training, validation, and test cohorts in a 7:1:2 ratio. Automatic lung segmentation and hand-crafted pneumonia lesion segmentation were performed, from which three image-based models including a full-lung model, a local-lesion model, and a context-fusion model were built; two clinical characteristics were used to build a clinical model, while a logistic regression model combined the best CNN model and two clinical characteristics. Our experiments showed that the context-fusion model which integrated the features of the full-lung and local-lesion had better performance than the full-lung model and local-lesion model. The context-fusion model had area under curves of 0.86, 0.88, and 0.93 in identifying viral, bacterial, and mycoplasma pneumonia on the test cohort respectively. The addition of clinical characteristics to the context-fusion model obtained slight improvement. Mycoplasma pneumonia was more easily identified compared with the other two types. Using chest radiographs, we developed a context-fusion CNN model with good performance for noninvasively diagnosing the etiology of community-acquired pneumonia in children, which would help improve early diagnosis and treatment.
