Pediatric Hospital Medicine 2012

The Role of Mycoplasma pneumoniae in Pediatric Lower Respiratory Tract Infection
Vanessa Hill
At the conclusion of this session, participants will be able to:

  1. Recognize the difficulties in testing for M. pneumoniae
  2. Examine the evidence surrounding the treatment of M. pneumoniae in LRT

Mycoplasma pneumoniae is the most widely studied of the human mycoplasma species; however, the lack of a true gold standard for clinical identification plagues the hospitalist in terms of evaluation and management. Furthermore, as the immunology of mycoplasma infection of the lower respiratory tract is more clearly elucidated, even more questions have arisen. The relatively new discovery of an intracellular existence has redirected research efforts to investigate the possible long term ramifications of infection, explore the concept of a carrier state in asymptomatic hosts as well as revisit our clinical approach to identification and treatment of mycoplasma infection. This seminar will necessarily focus on the uncertainty inherent in diagnosis, including the currently available tests and their pitfalls. Evidence for chronic infection, promotion of asthma symptoms, and carrier states will be reviewed. Finally, a review of the recent evidence on treatment in the common clinical scenarios where M. pneumoniae infection is considered will be provided, as will a risk-benefit analysis of treating in the setting of persistent diagnostic uncertainty.




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