Since the beginning of winter, the number of people suffering from coughs and runny noses has been increasing everywhere. Recently, with the spread of various viruses, the number of people going to hospital due to mycoplasma, which is said to be resistant to antibiotics, is increasing. This virus, which spreads mainly every 3-4 years, will cause a pandemic in 2019 and pneumonia-like symptoms in 2023, making pediatric and adolescent departments in hospitals particularly crowded. We learned about the symptoms and treatment of mycoplasma pneumonia.
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Q What are the symptoms that distinguish mycoplasma from the common cold?
A The difference compared to a common cold is that the fever is high, lasts a long time, the symptoms of cough and sputum are particularly severe and you feel muscle pain. Symptoms of mycoplasma that distinguish it from the flu include poor lung sounds and severe pneumonia when taking an x-ray or auscultation. The incubation period can last up to 2 or 3 weeks, so when symptoms appear it is impossible to guess who infected it. Being a bacterium, mycoplasma has the characteristic of continuing to worsen if not treated adequately, in particular cough, phlegm, fever, chills and sore throat can be serious. Mycoplasma can be suspected when such symptoms persist for quite a long time.
Q I heard you have to mix antibiotics?
A First, cold medicine treats the symptoms, but if the symptoms are treated without the cause being resolved, the symptoms will continue. So the way to treat the cause is to treat this bacteria. Antibiotics are used to treat bacteria. Although mycoplasma is prevalent, if a patient is suspected of having pneumonia, antibiotics targeting mycoplasma can be used empirically without testing. However, since mycoplasma no longer has a cell wall, general antibiotics do not work. Antibiotics are added to kill bacteria without cell walls, such as mycoplasma.
Q Why shouldn’t antibiotics be stopped even if symptoms improve?
A mycoplasma is a bacterium that does not have a cell wall. The bacterium can enter some cells and survive for a long time, and there are cases where it remains in the body for a long time even if it is healthy. When you are prescribed antibiotics, if you don’t use them for long enough and stop using them, or if you use them insufficiently, resistance can actually increase. Even if all symptoms are resolved, it is best to take sufficient medication for the specified treatment period.
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Q What is the difference between hospitalization and outpatient treatment?
A If the oxygen saturation is very low or if treatment with injection or oxygen is required, the patient will be admitted to hospital. Unless the patient is in these serious conditions, outpatient treatment is possible.
Q Is it possible to treat it even if it is resistant to antibiotics?
One mycoplasma was already about 80% resistant when it was detected in Korea in 2019. However, the guidelines call for the use of first-line drugs, and if the child has difficulty and does not respond to treatment, they can be added oral steroids. It changes from first-line drug to second-line drug, and second-line drug is a drug not approved for children under 18 years old or under 12 years old in Korea. Since this is an area that exceeds the permitted level, it can only be used when a specialist determines that the effectiveness outweighs the side effects. It is known that most cases of treatment are successful when secondary drugs are used.
Q Is there any other good fever reducer?
A There are two antipyretics: one is an antipyretic that acts on the fever center to reduce fever, and the other is an antipyretic that also acts on the fever center and has an anti-inflammatory effect. The reason mycoplasma produces fever, fatigue, and muscle aches is because the bacteria themselves enter the body and produce the inflammatory response. So, ibuprofen, which has an anti-inflammatory function that can calm the inflammatory response, might work a little better.
Q. Are adults equally infected?
A Adults can also be infected with mycoplasma. However, the most common symptom in case of infection with mycoplasma itself is asymptomatic. Some children with symptoms develop pneumonia, and the younger they are, the more likely they are to develop symptoms. So it may seem like it takes a lot, but in reality everyone can take it the same way.
Q. What is the mortality rate of mycoplasma? What are the prevention methods?
The rate of resistance to Mycoplasma is so high that people believe that even the use of drugs is useless and that the patient should simply get rid of the disease, but unfortunately there are very few cases where the patient ends up in the intensive care unit or dies . However, in very rare cases, less than 0.1% of cases progress to encephalitis. Therefore, in case of mycoplasma infection, if the child is very unconscious, has no way to eat or is in very poor condition, it is better to go to a higher level hospital and get tested for encephalitis, which is rare . Furthermore, since mycoplasma spreads through saliva droplets, infection can be minimized if both the infected person and surrounding people (family members) wear masks and it is important to follow general preventive rules such as hand washing.
Reporter Park Ji-hoon · Park Jun-seong, Professor, Pediatric Emergency Department, Asan Medical Center, Seoul
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