Symptoms and Diagnosis of Mycoplasma Pneumonia: What You Need to Know

Unlike typical bacterial pneumonia, mycoplasma pneumonia often develops gradually and presents with milder, flu-like symptoms that can be easily mistaken for a common cold or viral infection. This form of atypical pneumonia is caused by the bacterium Mycoplasma pneumoniae, which primarily affects the respiratory tract. Because its onset is slow and symptoms are non-specific, it may go unnoticed in the early stages.

Common Symptoms of Mycoplasma Infection

Individuals infected with mycoplasma may experience a range of systemic and respiratory symptoms. Early signs often include general fatigue, sore throat, persistent headache, and low-grade fever that can last for several days or even weeks. As the infection progresses, respiratory symptoms become more prominent.

Respiratory Manifestations

A hallmark symptom is a dry, persistent cough that may worsen over time and evolve into paroxysmal (sudden, intense) episodes. Some patients produce thin, watery sputum, although significant phlegm is uncommon. Chest discomfort or a burning sensation behind the sternum may accompany prolonged coughing fits. In more severe cases, shortness of breath may occur, particularly in individuals with pre-existing lung conditions.

Physical and Laboratory Findings

During a clinical examination, doctors may observe swollen lymph nodes in the neck, indicating the body's immune response. Despite noticeable symptoms, routine blood tests often show normal or slightly elevated white blood cell counts—this contrasts with typical bacterial infections, where white blood cells usually rise significantly.

Imaging and Diagnostic Testing

Chest X-rays typically reveal patchy infiltrates or segmental consolidation, most commonly affecting the lower lobes of the lungs. These radiological patterns are diverse and can mimic other types of pneumonia, making imaging alone insufficient for a definitive diagnosis.

For accurate identification, specialized laboratory testing is essential. Detection of M. pneumoniae antigens in respiratory specimens—such as nasopharyngeal swabs or sputum—can confirm active infection. Additionally, culturing the organism from sputum samples, though time-consuming, provides definitive evidence. Serological tests measuring antibody levels (IgM and IgG) are also used, especially in later stages of illness.

Treatment and Management

Macrolide antibiotics, such as azithromycin or clarithromycin, are the first-line treatment for mycoplasma pneumonia, particularly in children and young adults. In cases of macrolide resistance or allergies, alternative options like tetracyclines (e.g., doxycycline) or fluoroquinolones (e.g., levofloxacin) may be prescribed for adults.

Most patients recover fully with appropriate antibiotic therapy and supportive care, including rest, hydration, and over-the-counter medications to manage fever and discomfort. Hospitalization is rare and generally reserved for severe cases or high-risk individuals, such as the elderly or those with compromised immune systems.

Prevention and Public Awareness

Since mycoplasma spreads through respiratory droplets, good hygiene practices—like frequent handwashing and covering the mouth when coughing—are key to reducing transmission. Outbreaks are common in crowded settings such as schools, dormitories, and military barracks, highlighting the importance of early detection and isolation when symptoms appear.

Understanding the subtle yet distinctive features of mycoplasma pneumonia enables earlier diagnosis and treatment, reducing complications and limiting its spread within communities. If you're experiencing a prolonged cough with fever and fatigue, especially during peak respiratory illness seasons, consulting a healthcare provider for proper evaluation is strongly recommended.