Complications

Complication
Timeframe
Likelihood
short term
high

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.

short term
medium

Cholestatic hepatitis may accompany Mycoplasma pneumoniae pneumonia in pediatric patients and, less frequently, in adults.[63][64] The presence of hepatitis with pneumonia might suggest that M pneumoniae is a possible pathogen.

Evaluation of liver dysfunction

short term
low

Accumulation of fluid in the pericardial space, mainly seen in Mycoplasma pneumoniae and Legionella pneumophila infections.[4][61] If abnormalities do not resolve with antibiotic treatment, the patient may require pericardiocentesis and drainage.

Pericarditis

short term
low

Hematologic disorders may be attributed to the presence of cross-reacting cold agglutinins in Mycoplasma pneumoniae infection. These include hemolytic anemia, methemoglobinemia, and coagulation disorders such as disseminated intravascular coagulation or thrombotic thrombocytopenic purpura.[4][62]

short term
low

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[65] and is more likely in pediatric patients;[66] antibiotic treatment is considered essential. If fluid accumulates or does not resolve, thoracentesis and drainage may be indicated. In severe nonresolving cases, pleural decortication may be required.

Pleural effusion

variable
medium

In up to 7% of patients hospitalized with Mycoplasma pneumoniae, a neurologic 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.

variable
medium

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 hypogammaglobulinemic patients.[4]

Use of this content is subject to our disclaimer