Mycoplasma pneumoniae causes (lobar pneumonia/bronchopneumonia/atypical pneumonia) .
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 19-year-old navy recruit comes to the office because of non-productive cough, headache, fever, rhinorrhea, and myalgias for a week. He says that many of the other recruits in his unit are also sick with the same symptoms. His temperature is 37.8ºC (99.3ºF), pulse is 110/min, respirations are 22/min, and blood pressure is 116/82 mm Hg. Widespread rales are heard on chest auscultation. There is also a red rash present on his limbs and torso. Blood cultures are ordered. Which of the following growth medium would be most effective in culturing the common organism responsible for the patient’s condition?
Mycoplasma, as a genus, have a cell membrane that is packed with sterols, but they lack a proper, rigid cell wall.
Therefore, they don’t take up dye under Gram staining, so they can’t be visualized with light microscopy.
Additionally, they are highly pleomorphic bacteria, meaning they have no fixed shape and size, and they’re also osmotically unstable in the external environment.
So, to survive, Mycoplasmas invade host cells and live intracellularly.
So it prefers places like lungs or respiratory airways, where there is an unlimited flow of oxygen.
As a result, some people may carry this bacteria in their nose or throat, and when they sneeze or cough, these organisms get out in the form of small respiratory droplets.
And when other people inhale these droplets, they may get infected, especially when they spend a lot of time together in close quarters.
So Mycoplasma pneumoniae infections occur mostly in children who go to school, young adults in college, or military recruits.
Following inhalation of the pathogen droplets, Mycoplasma pneumoniae attaches to an epithelial cell in the respiratory tract, using a specialized attachment organelle which has an adhesive protein complex, called ‘adhesion protein P1’ at its tip.
Adhesion protein P1 attaches to the host cell surface, like the respiratory epithelial cell, and holds on for dear life.
This makes it much harder for the mucociliary clearance mechanisms, which normally remove any foreign pathogen out of the respiratory tract, to clear the bacteria.
So Mycoplasma pneumoniae multiplies and damages the respiratory epithelial cells in the process.
When they reach the lungs, this starts a local inflammatory response, and lung tissue fills with white blood cells, proteins, fluid, and even red blood cells if a nearby capillary gets damaged in the process - leading to a local cytotoxic effect.
So Mycoplasma pneumoniae avoid the battlefield by sneaking inside lung cells, where they remain dormant or replicate intracellularly.
As a result, individuals infected by Mycoplasma pneumoniae are often asymptomatic or may have nonspecific symptoms like fatigue, sore throat, mild fever and dry hacking cough - all of which aren’t typical of bacterial pneumonia - hence the name atypical pneumonia.
Besides, the person may not feel very sick, as opposed to a person suffering from other bacterial pneumonia - where they’ll surely be bedridden and suffering from more severe symptoms like dyspnea, or shortness of breath, fever, chest pain, and a productive cough.