Complications
May occur in up to 25% of patients with Mycoplasma pneumoniae, and is mainly a self-limiting maculopapular or vesicular rash.[4] Severe cases may include Stevens-Johnson syndrome and ulcerative stomatitis. As the main cause for the rash is probably due to systemic spread of the pathogen to the skin, antibiotic treatment should be considered.
Haematological disorders may be attributed to the presence of cross-reacting cold agglutinins in Mycoplasma pneumoniae infection. These include haemolytic anaemia, methaemoglobinaemia, and coagulation disorders such as disseminated intravascular coagulation or thrombotic thrombocytopenic purpura.[4][61]
Accumulation of fluid and inflammatory cells from an adjacent lung infection or due to invasion of the pathogen to the pleural space occurs in rare cases of Mycoplasma pneumoniae pneumonia[64] and is more likely in paediatric patients;[65] antibiotic treatment is considered essential. If fluid accumulates or does not resolve, thoracentesis and drainage may be indicated. In severe non-resolving cases, pleural decortication may be required.
In up to 7% of patients hospitalised with Mycoplasma pneumoniae, a neurological complication develops. These can occur up to 2 weeks after the onset of infection and may include encephalitis, meningitis, cerebellar syndrome, cranial nerve palsies, and Guillain-Barre syndrome.[4] These complications may be related to autoimmune conditions.
Myalgias, arthralgias, and polyarthropathy can occur in up to 14% of patients with Mycoplasma pneumoniae acute infection and can persist long after the infection. This is more common in hypogammaglobulinaemic patients.[4]
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