Mycoplasma infections - mucocutaneous features

LAST UPDATED: Sep 23, 2022

Introduction

Mycoplasmas are the smallest free‐living organisms. There are several species, some of which are commensals, others that are associated with skin lesions in patients with AIDS and other immunocompromised conditions, and Mycobacteria pneumoniae, which is associated with the most frequent mucocutaneous features. This chapter, which focuses on Mycoplasma pneumoniae, is set out as follows:

Clinical findings
Images
Investigations
Management

Clinical findings

Clinical features of M. pneumoniae

Mucocutaneous features - occur in up to 1/3 of cases of upper respiratory infection by M. pneumoniae, sometimes the respiratory / systemic symptoms are minimal. Clinical features can include:

A subtle annular rash
Urticaria
Erythema multiforme lesions
Mucosal changes
Up to 7% of cases of Stevens-Johnson syndrome / toxic epidermal necrolysis are caused by M. pneumoniae

Systemic features - include pneumonia and minor upper respiratory tract infections (particularly in young people), meningoencephalitis, polyarthritis, and other syndromes

Clinical Images

Please refer to notes on image rights at bottom of the page with regards to individual image ownership.

Lesions of erythema multiforme can be associated…

Stevens-Johnson syndrome can be associated…

Investigations

Serology for M. pneumoniae
CXR

Management

M. pneumoniae responds best to the macrolides (clarithromycin or azithromycin) and the second-generation tetracyclines (lymecycline and doxycycline)

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