Symptomy nemoci, rizika a komplikace

Komplikace

Mykoplasma pneumoniae

Plicní

• Asthma [5]
• Lobar consolidation [6]
• Abscess
• Pleural effusion (15-20%) [6]
• Empyema (rare) [6]
• Bronchiolitis obliterans [6]
• Necrotizing pneumonitis [6]
• Severe pneumonia [3]

• Death
• Due to lesions and ulceration of the epithelial lining
• Pulmonary edema
• Bronchiolitis obliterans [5]
• Acute respiratory distress syndrome [6]
• Respiratory failure [6]

• Extrapulmonary symptoms in up to 25% of cases
• Autoimmune responses
• Central nervous system complications
• Dermatological disorders [5]

ORL

• Ear infections [3]

Krevní a cévní

• Hemolytic anemia [3]
• If the IgM antibodies to M pneumoniae antigens cross react to antigens on human erythrocytes
• Krize u srpkovité anemie
• Associated with acute chest syndrome in patients with sickle cell anemia [6]
• Vaskulitida a trombozy [5]
• Immune thrombocytopenic purpura [6]
• Severe autoimmune hemolytic anemia [6]

Kožní

• Skin rashes [3]
• Erythema multiforme
• Macular exanthems
• Vesicular exanthems
• Urticaria
• Erythema nodosum
• Stevens-Johnson syndrome [6]

Musculoskeletal problems

• Arthritis is rare [4,6]
• Arthralgia
• Myalgias
• Rhabdomyolysis
• Linked with M pneumoniae infections, with very high CPK and myoglobin levels reported

Neurologické

• Guillain-Barré syndrome [4]
• Encephalitis [4]
• Transverse myelitis [6]
• Aseptic meningitis
• Peripheral neuropathy
• Cerebellar ataxia
• Some of the CNS sequelae may be permanent
• May be linked to an immunologic reaction to antigens produced by the infection [6]

Cardiac problems

• Conduction abnormalities
• Rhythm disturbances
• Heart blocks on the ECG [6]
• Chest pain from pericarditis or myocarditis
• Linked to anti-cardiolipin antibodies [6]
• Congestive heart failure
• Myocardial damage has been reported in children with M pneumoniae pneumonia [6]

Gastrointestinal problems

• Nonspecific [6]
• Hepatitis acute [6]
• Pancreatitis
• Related to circulating antibodies [6]

Ophthalmologic problems

• Most commonly conjunctivitis
• Cranial neuropathies
• Optic papillitis
• Anterior uveitis [6]
• Conjunctivitis
• Anterior uveitis
• Optic neuropathy
• Retinitis
• Retinal hemorrhages
• Iritis
• Optic disk swelling
• With or without permanent degradation of vision [8]

Renal problems

• Glomerulonephritis rare complication
• Likely caused by immune complex deposits in the glomerulus [6]

Apigenin

• Suppresses mycoplasma-induced alveolar macrophages necroptosis
• Via enhancing the methylation of TNF-? promoter by PPAR?-Uhrf1 axis
• Current anti-mycoplasma agents used in clinical practice do not prevent dysfunction of alveolar macrophages
• Caused by the high level of the cytokine TNF-a after mycoplasma infection
• Apigenin inhibits the production of TNF-a in variet inflammation associated disease.
• Promoted alveolar macrophage survival.
• pubmed.ncbi.nlm.nih.gov/36332388/

Úvahy 28.4.2024

• tohle může být dobré při těžkém zánětu, ale může to být mínus v případě infekce makrofágů a riziku roznášení infekce jejich cestou
• jak je to u mykoplasmy - umí infikovat přímo makrofágy ?
• jsou makrofágy důležité pro její clearance ?

Coinfections

• Complex multiple infections
• Present in up to 80% of chronic Lyme diseases cases

Multiple Systemic Infectious Disease Syndromes (MSIDS)

• Significant treatment challenge to practitioners
• Number of infections involved
• Wide variety of symptoms found
• Difficulty of finding effective treatments

Koinfekce

• M. pneumoniae + various viruses or bacteria reached 52% [8]
• With S. pneumoniae cca 51.4% [8]
• M. pneumoniae + S. pneumoniae cca 10%
• Prolongs the course of the disease [8]
• Mycoplasma pneumoniae is one of the main causes of persistent cough in patients infected with Bordetella pertussis
• Persistent cough that lasted less than 100 days in 56% [8]
• When the cough lasted for more than 100 days, B. pertussis was involved in 83% of cases [8]
• Chlamydophila pneumoniae in 17% [8]
• Bordetella parapertussis in 2% [8]
• M. pneumoniae in co-infection with other agents in 26% [8]
• Co-factor in 14 out of the 65 episodes [8]
• Important catalyst of recurrent-respiratory-tract infections [8]

M. fermentans infections

• Can cause cardiovascular and pulmonary manifestations
• Can result in extreme patient morbidity
• Vascular occlusion due to thrombosis
• Caused by stimulation of autoimmunity
• Formation of vascular immune complexes
• Vascular occlusion has been reported for
• Heart, lung, kidney, brain and other organs in pathogenic mycoplasma infections
• www.scirp.org/journal/paperinformation.aspx?paperid=95720

Asociované symptomy

• únavového syndromu [2]
• Fibromyalgického syndromu [2]
• Syndromu Války v zálivu [2]
• Revmatoidní artritidy [2]

Chronické symptomy

• Intermitentní (přerušované) horečky včetně nočních potů [2]
• Chronická únava [2]
• Kožní zarudnutí [2]
• Zvýšená kožní citlivost [2]
• Bolesti kloubů a svalů [2]
• Otoky se sníženou pohyblivostí kloubů [2]
• Bušení srdce [2]
• žaludeční křeče [2]
• Dvojí vidění a další [2]

Major cause of asthma attacks in children

• Involved in 2%-4% of asthma attacks with a detectable infectious agent [8]
• Cause of asthma attacks in 50% of 119 hospitalized children [8]
• Worsening factor in 20% of them [8]
• Antibiotic treatment is not routinely recommended in an asthma crisis
• Even when it is severe
• Or when it is associated with fever
• "because the main causative agent is the viruses" [8]

Chronic-interstitial-pulmonary fibrosis

Swyer-James syndrome

Astma

• M. pneumoniae infections linked to respiratory asthma (MP-RA), particularly in children
• Link between serum immunoglobulin, inflammatory variables, vitamin A, and vitamin D levels in MP-RA patients
• From January 2015 to March 2020 screened for pneumonia mycoplasma infection (MP)
• 55 cases of healthy control children (HC),
• 53 instances of mycoplasma pneumonia infection complicated with respiratory asthma (MP-RA)
• 58 cases of non-respiratory asthma children
• Serum TNF- and IL-1b levels
• Were greater in MP-RA children than in MP children
• 25(OH)D, IgG, and IgA levels were lower
• TNF-a, IL-1b, 25(OH)D (Vit-D), IgG, and IgA were the predictors in the prediction nomogram
• Combined influence of serum inflammation in MP-RA
• TNF-a, IL-1b, 25(OH)D (Vit-D), IgG, and IgA were considered as predictors in children with MP-RA

• Mpn may also be a direct cause or significant cofactor in many extrapulmonary diseases including
• Rheumatoid arthritis
• Encephalitis,
• Aseptic meningitis,
• Acute transverse myelitis,
• Stroke,
• Chronic fatigue,
• Polyradiculopathy

• The central nervous system (CNS): Rare but can include encephalitis, transverse myelitis, aseptic meningitis, and cerebellar ataxia. These CNS complications are more common in children.
• Hematologic problems: Hemolytic anemia due to cross-reactivity of antibodies to M. Pneumoniae antigens to red blood cells. The hemolysis is mild.
• Dermatology: M. Pneumoniae infection may be associated with urticaria, erythema nodosum, or steven johnson syndrome. The skin lesions are seen in about one-third of patients.
• Musculoskeletal problems include myalgia and arthralgia. Septic arthritis is very rare. Rare cases of rhabdomyolysis have been reported.
• Gastrointestinal (GI) dysfunction include pancreatitis or hepatitis and are linked to the circulating IgM antibodies.
• Ophthalmologic problems include conjunctivitis, optic papillitis, anterior uveitis, and cranial neuropathies.
• Kidney problems are rare and may result in glomerulonephritis due to immune complex precipitation in the glomeruli.

https://www.ncbi.nlm.nih.gov/books/NBK430780/

Mycoplasma hominis and Ureaplasma urealyticum

• Common inhabitants of the human genital tract

Can play an etiologic role in

• Pyelonephritis,
• Pelvic inflammatory disease
• Post-abortion and post-partum fevers
• Septicemia,
• Septic arthritis
• Neonatal meningitis and encephalitis
• M. fermentans
• Can cause severe neurological signs and symptoms after injection into the cerebral fluid of rats

• Mycoplasmas contain the smallest known self-replicating genomes
• Unusually low G + C content (25% - 33%)
• Small genomes of M. genitalium and M. pneumoniae encode approximately 400 - 600 proteins
• Mycoplasmas still maintain all of the essential genes for replication, transcription, and translation as well as the minimal number of energy metabolism genes needed for their parasitic modes of life

Mycoplasma spp are etiologic agents of

• Pneumonias,
• Non-gonococcal urethritis,
• Endometritis,
• Chorioamnionitis,
• Infertility in both immunosuppressed and immunocompetent individuals
• Role in development of autoimmune diseases such as asthma

https://www.biorxiv.org/content/10.1101/535559v1.full

Many M. pneumoniae infections

• Asymptomatic
• Symptoms are typically more significant than objective findings on physical exam
• Disease onset is gradual
• Initially complain of headaches, malaise, and low-grade fever
• Nagging cough is usually the most prominent respiratory feature
• Chest soreness from coughing is common
• Wheezing can also occur
• Pharyngitis, rhinorrhea, and ear pain
• Pleural effusion occurs in 15% to 20% of patients who develop pneumonia
• May predict increased morbidity and mortality
• Most cases of pneumonia are mild and self-limited

• Extrapulmonary features
• Hemolysis,
• Skin rash,
• Joint pain,
• Gastrointestinal (GI) symptoms,
• Heart disease.
• In less than 5% to 10% of patients

• Hemolysis
• Occurs due to IgM antibodies producing a cold agglutinin reaction.

• Cardiac involvement
• Conduction abnormalities on ECG
• Congestive heart failure
• Chest pain

• Physical examination findings are often minimal.
• Chest auscultation can be normal even if pneumonia is present.
• Scattered rales, wheezes can present later in the course of the disease.
• Sinus tenderness and mild erythema of the posterior pharynx may also be found on physical examination.
• A mild erythematous maculopapular or vesicular rash may also be found.
• Bullous myringitis, the presence of vesicles or bulls on the tympanic membrane, can be seen in some cases.
• www.ncbi.nlm.nih.gov/books/NBK430780/

Antibodies produced against M. pneumoniae

• May act as autoantibodies
• Crossreact with human brain cells and RBCs
• Immune thrombocytopenic purpura
• Acute hepatitis,
• Autoimmune hemolytic anemia,
• Arthritis,
• Transverse myelitis

Refrakterní mykoplazmová infekce

• Differences between the refractory group and the general group
• Heat duration,
• Hospitalization time,
• Hypoxemia, lung rales,
• CRP, ESR, PCT, LDH, ALT, PLT, WBC,
• D dimer
• Other laboratory examinations
• Intrapulmonary and extrapulmonary complications
• Treatment (all P<0.05)
• Unilateral pulmonary shadow and atelectasis
• More attention
• May be a high-risk factor for the development of RMPP
• Inflammation index of RMPP cases increased and there were many complications inside and outside the patients’ lungs.

It was necessary to give

• Enough macrolides
• Glucocorticoid
• Intravenous immunoglobulin
• Fiberoptic bronchoscopy was completed to improve the effectiveness of the diagnosis and treatment

Submitted Nov 14, 2019. Accepted for publication Aug 04, 2020. doi: 10.21037/apm-19-497

Oral Infections

• High incidence in patients with gingivitis and periodontitis
• From almost all saliva and plaque samples in children with gingivitis
• Able to induce cytokine secretion by gingival fibroblasts
• Routinely found in the oral cavities of normal hosts where they apparently do not cause hit no symptoms

Airway Inflammation

• Airway inflammation
• Induction of bronchial hyper-responsiveness (BHR)
• Production of M. pneumoniae-specific IgE and IgA
• Elevated IgE antibodies specific to M. pneumoniae
• Children with M. pneumoniae pneumonia
• Patients with preexisting asthma-BHR
• Severe asthma-BHR attacks in adults
• 24.7% of patients with asthma, only in 5.7% of control subjects

Urogenital Infections

• M. genitalium, M. fermentans, M. hominis, M. pneumoniae and Ureaplasma urealyticum
• M. hominis and U. urealyticum in a wide variety of urogenital diseases
• Pelvic inflammatory disease,
• Infertility,
• Non-gonococcal urethritis (NGU)
• Other genital infections
• Urethra, fetal-placental tissue, cervix, endometrium, vagina, various wounds, and from urine, blood, peritoneal fluid, and amniotic fluid.
• M. hominis
• Strongly associated with bacterial vaginosis
• Appearance of various pathogenic mycoplasma species in bacterial vaginosis
• Result of pathophysiological alterations of the vaginal ecosystem
• Mycoplasmas appear to play an important role in this process

• U. urealyticum
• Acute NGU
• Its chronic forms in men
• In a majority of male patients with NGU,
• Sexually transmitted U. urealyticum, M. hominis or Chlamydia trachomatis infections
• In approximately one-half of 400 young symptomatic females under the age of 30
• Majority of 86 pregnant women with sexually transmitted diseases
• Infections with pathogenic mycoplasmas are thought to be an important cause or cofactor
• In many urogenital inflammations, fertility problems and premature deliveries.

• M. fermentans, M. penetrans, and M. pirum
• In urethral swab specimens collected from male patients with or without acute NGU
• M. fermentans was not detected by PCR or culture methods in patients with urethritis or cervicitis
• Was detected by PCR in 4 of 232 amniotic fluid samples tested
• These four cases M. fermentans was transferred transplacentally
• Evidence of chorioamnionitis was present in two of the four patient

Infertility and Spontaneous Abortion

• Known to reduce fertility rates
• U. urealyticum
• Number of patients with fertility problems in both women and men
• Successful treatment has been correlated with improvements in fertility
• In men U. urealyticum infection
• Reduce sperm motility and viability
• Directly related to fertility
• Treatment of this infection resulted in improvements in quantity, motility, and appearance of sperm, improvements in fertility -Multiple studies on several species
• Pathogenic mycoplasma infections are a risk factor for male infertility

• Vaginal mucosal surfaces of the cervix or vagina
• Is not necessarily an indication of infertility
• U. urealyticum and M. hominis
• May occur in 40% to 80% of asymptomatic women
• Inflammatory infections of the upper urogenital tract
• Related to mycoplasmal infections
• Good correspondence with infertility
• Infections of the lower genital tract not well correlated with
• Infertility
• Adverse pregnancy outcomes
• Pathogenic mycoplasma infections of the upper tract and chorioamnion
• Strongly associated with adverse pregnancy outcomes
• Experimental animal infections is even clearer
• Spontaneous abortions
• Higher risk of birth complications
• Post-Cesarean delivery endometritis
• Important risc factor for
• Prematurity, pregnancy loss,
• Chorioamnionitis
• Other complications
• Can invade the amniotic cavity and cause intense inflammatory reactions in the absence of labor

Immunosuppressive Diseases

HIV-1 virus

• Various Mycoplasma spp. as infectious cofactors along with HIV-1 virus in the pathogenesis of HIV-AIDS
• Systemic mycoplasmal infections in HIV-AIDS patients
• Much higher than previously thought
• Direct activation or suppression of the immune system
• Superantigens + alterations in immune responses
• Contribution to the oxidative stress in HIV-positive patients
• Mycoplasma fermentans
• First mycoplasma species reported in AIDS patients
• Important cofactor in the progression of AIDS
• Co-infection with HIV-1 in cca one-half of patients with AIDS
• Mycoplasma molecular mimicry may be involved in the pathogenesis of AIDS
• Antigen similarities, similar mechanisms for cell entry
• HIV-1 gp120 envelope glycoprotein and M. genitalium adhesin proteins
• Share sequence homology
• Significant similarity with the CD4-binding site of the class II major histocompatibility complex (MHC)
• Pathogenic mycoplasmas with MHC-related antigens on host cells
• Could contribute to
• T-cell dysfunction,
• T-cell depletion,
• T-cell shift,
• B-cell proliferation,
• Hyperglobulinemia
• Antigen-presenting cell dysfunction
• Observed during the development and progression of HIV-AIDS

Rheumatic Diseases

• Underlying causes of rheumatic diseases remain unknown
• Involve, at least in part, infectious agents
• Progression of rheumatic diseases related to infectious processes
• Similarities support microbial etiology
• Long list of microorganisms proposed as important factors
• Aerobic and anaerobic bacteria
• Viruses
• Pathogenic mycoplasmas
• May promote the progression of rheumatic diseases

Rheumatoid arthritis (RA)

• Mycoplasmas have been proven to cause arthritis in animals
• Various pathogenic species detected in the synovial fluid and blood of RA and other arthritis patients
• Various species of pathogenic mycoplasmas localized in the joint tissues of patients with arthritis
• Known to be able to induce immune dysfunction and autoimmune reactions
• Related to the development of arthritis
• Mycoplasmal infections could be involved in the pathogenesis of RA
• Arthritis, M. arthritidis-related superantigens
• Found to compromise T-cells
• Can trigger and exacerbate autoimmune arthritis
• Superantigens involve parts of a T-cell receptor
• Proposed to be involved in arthritis
• Mycoplasmas can release substances
• Oxygen free radicals
• Chemotactic
• Aggregating substances
• Could interact with mononuclear and other cell types.
• Injection of isolated membranes from M. arthritidis
• Resulted in toxicities in animals similar to those found in rheumatic disease
• Similarity of antigenic epitopes of chondrocytes and M. arthritidis membrane components
• Trace amounts of pathogenic mycoplasmal antigens or specific antibodies against pathogenic mycoplasma
• Found quite often in RA patients

Cardiovascular Diseases

• Reported different forms of carditis
• In chronic M. pneumoniae infections also
• Endocarditis and myocarditis
• Important causes in the fatal outcomes in M. pneumoniae-infected patients
• Direct invasion of M. pneumoniae into pericardial tissue
• Likely cause of pericarditis

Autoimmune Diseases

• Role in many autoimmune diseases
• Intracellular replication and release from host cells
• Mycoplasmas can capture antigens from the host cell surface and incorporate them into their cell membranes
• Concomitant immune responses against these host antigens and possibly autoimmune reactions
• Mycoplasmal antigens often mimic host antigens
• Responses are generated against these mycoplasmal antigens
• Result could be cross-reactivity
• Mycoplasmas can cause apoptosis of host cells
• Release of normal host antigens that could elicit host autoimmune responses.
• Mycoplasma superantigen immunomodulator
• Found during M. pneumoniae infections
• Cause transient autoimmune hemolytic disorders
• High titers of autoantibodies against carbohydrate antigens
• Effects of super-antigens on immune systems
• Binding to the outer portions of MHC structures on antigen-presenting cells
• To the non-antigen recognizing structures of the hypervariable regions of T-cell antigen receptors
• Can also induce immunological tolerance
• Injected into mice, M. arthritidis super-antigen
• Causes a chronic arthritis that resembles RA histologically
• Super-antigen (MAM) that in humans preferentially expands T-cells
• Antigen receptors (TCR) express the segment Vbeta17
• T cells with this phenotype appear to be increased in frequency in RA synovial effusions
• Kawasaki disease,
• Sjögren syndrome,
• Lupus erythematosus
• Multiple sclerosis
• Oligoclonal expression of TCR beta specificities on infiltrating T-cells

Neurodegenerative and Neurobehavioral Diseases

• Direct penetration of the blood-brain-barrier
• Intraneuronal transfer
• Carried inside infiltrating mononuclear cells
• Dementia and other brain impairments
• Overlap with neurodegenerative diseases in their signs and symptoms
• Stroke, dementia, multiple sclerosis and other
• Autism spectrum disorders, attention deficit disorders and other brain developmental impairments
• Poorly understood and generally poorly addressed clinically

ALS

• Adult onset neurodegenerative disease, amyotrophic lateral sclerosis (ALS)
• Example of a progressive CNS disease that ultimately results in death
• Pathogenic mycoplasmal infections were found to be quite common in veterans and civilians with ALS
• 83% of ALS patients showing positive blood results x less than 9% of controls
• Some of these ALS patients also were positive for Borrelia infections
• All of the Gulf War veterans with ALS - mycoplasma-positive
• Almost all had M. fermentans infections
• Many patients with an incomplete diagnosis of ALS
• Also positive for mycoplasmal infections
• A recent study found that 46% of civilian ALS cases were positive by PCR

Multiple sclerosis (MS)

• Evidence of chronic viral and bacterial infections
• Mycoplasmal infections were rarely found in brain tissue
• Female MS patients in remission have higher levels of M. pneumoniae antibodies in their serum
• Suggesting that mycoplasmal infection(s) may be, in fact, related to progression in certain MS patients
• A more common finding was the presence of Chlamydia pn. in MS patients
• Presence of various viruses, including human endogenous retroviruses

Autism spectrum disorders (ASD) in children

• High frequencies of chronic bacterial and viral infections
• Several Mycoplasma species, Chlamydia pneumoniae, and human herpes-6 co-infections
• Were found in the blood of a majority of children with ASD
• Association has also been found between ASD and Borrelia burgdorferi infections
• Resulted in a proposal for long-term antibiotic therapy for children with ASD and associated conditions

Fatiguing Illnesses

• Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis
• Disabling fatigue plus additional signs and symptoms
• Most patients evidence of chronic viral and bacterial infections OR 18.0 (p < 0.001)
• CFS patients have a very high probability of multiple chronic infections
• By PCR of blood monocytes
• Various pathogenic species of mycoplasmas
• M. pneumoniae was the most common followed by
• M. fermentans,
• M. hominis,
• M. penetrans
• European CFS patients in different frequencies
• M. hominis was the most commonly found pathogenic mycoplasma in European CFS patients
• Patients with multiple infections
• Have a more severe illness - signs and symptoms
• Fibromyalgia (FM)
• Many of the signs and symptoms of CFS
• Characteristic symptoms are diffuse widespread pain and other
• Overlapping signs and symptoms
• Widespread pain is the most characteristic symptom
• Spontaneous pain, burning pain, pressure pain, and combinations
• Various viral and bacterial infections have been found
• Pathogenic species of Mycoplasma
• Fatiguing illness is Gulf War Illness (GWI)
• Loosely fits the symptom profile of CFS
• Fatigue, pain, cognitive problems, gastrointestinal symptoms and respiratory and skin problems
• By multiple hits
• Majority of these were found to be M. fermentans infections
• Treating such infections with long-term anti-microbial therapy resulted in recoveries
• Not with every patient

Other Illnesses and Conditions

• Guillain-Barré syndrome
• Muscle weakness, pain, numbness, tingling in the arms, face and legs, among other symptoms
• Demyelinating neuropathy
• Often associated with bacterial infections
• M. pneumoniae infections are commonly found in over one-half of Guillain-Barré syndrome patients
• Infectious illnesses like PANDAS (pediatric autoimmune neuropsychiatric disorders associated with Strepococci)
• Tourette’s syndrome
• Related to the involvement of bacterial co-infections
• Borrelia spp. and Mycoplasma pn.
• Number of cancers
• Lymphomas
• Oral carcinomas
• Prostate cancers
• Lung cancers
• Can promote malignant transformation in vitro and in vivo
• Vasculitis,
• Dermatitis,
• Neuritis,
• Hepatitis,
• Sarcoidosis,
• Encephalitis,
• Pancreatitis,
• Hematologic illnesses, ...

Respirační infekce

• Faryngitis
• Tracheobronchitis
• Bronchitis
• Bronchiolitis
• Pneumonitis
• Otitis acuta
• Bulózní hemorrhagická myringitis - některé studie vyloučily tuto souvislost [6]

Pneumonie atypická

• Atypical bacterial pneumonia related to cold agglutinin disease - human primary atypical pneumonia (PAP) - "walking pneumonia" [5]
• Common cause of "Community-acquired pneumonia (CAP)" [6]
• Should be considered as a possible etiology in any patient who presents with 3 weeks or more of a steadily progressive cough [6]
• Seek relief from the persistent, worsening cough [6]
• Occasionally, various pulmonary and extrapulmonary complications may occur [6]
• Nejč. 5-15 let [2]
• Malý fyzikální nález [2]
• Rozsáhlý RTG nález [2]
• Inkubační doba po infekci cca 2-3 týdny [2]
• Prolonged, gradual onset [6]
• Prolonged paroxysmal cough [6]
• Due to the inhibition of ciliary movement [6]
• Sloughing of the respiratory epithelial cells [6]
• Horečka, bolesti hlavy a neklid [2]
• Přetrvávající neproduktivní dávivý kašel [2]
• Often mild po 1 - 3 weeks, may become more severe in some people [3]

Common symptoms:

• Chest pain
• Chills
• Cough
• Usually dry, not bloody [3]
• Excessive sweating
• Fever (may be high)
• Headache
• Sore throat [3]
• Sore trachea

Less common symptoms include:

• Ear pain
• Eye pain or soreness
• Muscle aches and joint stiffness
• Neck lump
• Rapid breathing
• Skin lesions or rash [3]

• Primary atypical pneumonia
• One of the most severe types of manifestation
• Tracheobronchitis
• The most common symptom
• Up to 18% of infected children require hospitalization [5]
• Upper respiratory tract disease
• 15% of cases, usually adults, remain asymptomatic [5]

• Symptom intensity and duration can be limited by early treatment with antibiotics:
• Sore throat scratchy
• Wheezing and coughing
• Fever - generally low-grade [6]
• Headache
• Coryza
• Myalgia
• Feelings of unease [5]
• Malaise [6]
• Persistent, slowly worsening, incessant cough [6]
• From non-productive to mildly productive
• Sputum discoloration developing late in the course of the illness [6]
• The absence of cough makes the diagnosis of M pneumoniae unlikely [6]
• Chills but not rigors [6]
• Sore chest and tracheal tenderness (result of the protracted cough) [6]
• Pleuritic chest pain (rare) [6]
• Wheezing [6]
• Dyspnea (uncommon) [6]

• Mild pharyngeal injection
• With minimal or no cervical adenopathy
• no exudate [6]
• Normal lung findings with early infection
• But rhonchi, rales, and/or wheezes several days later [6]
• Various exanthems including [6]
• Erythema multiforme
• Stevens-Johnson syndrome
• Sinus tenderness may be present [6]

Mycoplasma hominis

• Hluboký pánevní zánět (pelvic inflammatory disease, PID)
• Poporodní horečku
• Popotratovou horečku
• Extragenitální infekce u imunosuprimovaných jedinců
• Meningitidy, pneumonie a abscesy u novorozenců

Mycoplasma genitalium

• Negonokoková uretritida
• Cervicitida
• Hluboký pánevní zánět
• Spojitost s neplodností a potraty nebyla uspokojivě prokázána [1]

Infectious arthritis/septic arthritis

• Blood and lung infection in newborns (neonatal bacteremia/pneumonia)
• Inflammation of the covering of the brain in newborns (neonatal meningitis)
• Disorders of the eye and ear
• Periodontal disease and gingivitis
• Crohn’s Disease and Irritable Bowel Syndrome
• Inflammation of the uterus (endometritis or chorioamnionitis) in pregnant and non-pregnant

women

• Pelvic inflammatory disease
• Kidney infection (pyelonephritis)
• Surgical wound infections
• Inflammation of the urethra, which carries urine from the bladder t-outside the body

• Various Mycoplasmas have been found associated with chronic diseases such as
• Lyme Disease,
• Alzheimer’s,
• Fibromyalgia,
• Gulf War Syndrome,
• Multiple sclerosis,
• Chronic fatigue,
• ALS,..

• sarasgarden.org/wp-content/uploads/2013/12/Mycoplasma-HBOT.pdf