マイコプラズマ肺炎
- 関
- primary atypical pneumonia
WordNet
- respiratory disease characterized by inflammation of the lung parenchyma (excluding the bronchi) with congestion caused by viruses or bacteria or irritants
- any of a group of small parasitic bacteria that lack cell walls and can survive without oxygen; can cause pneumonia and urinary tract infection
PrepTutorEJDIC
- 肺炎
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/10/18 01:57:07」(JST)
[Wiki en表示]
| Mycoplasma pneumonia |
| Classification and external resources |
| Specialty |
Infectious disease |
| ICD-10 |
B96.0 |
| ICD-9-CM |
483.0 |
| MedlinePlus |
000082 |
| eMedicine |
emerg/467 |
| MeSH |
D011019 |
|
[edit on Wikidata]
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Mycoplasma pneumonia (also known as "walking pneumonia" because its patients can sometimes continue to walk about while suffering from its symptoms) is a form of bacterial pneumonia caused by the bacterial species Mycoplasma pneumoniae.
Contents
- 1 Pathophysiology
- 2 Diagnosis
- 3 Treatment
- 4 References
Pathophysiology
Mycoplasma pneumoniae is spread through respiratory droplet transmission. Once attached to the mucosa of a host organism, M. pneumoniae extracts nutrients, grows, and reproduces by binary fission. Attachment sites include the upper and lower respiratory tract, causing pharyngitis, bronchitis, and pneumonia. The infection caused by this bacterium is called atypical pneumonia because of its protracted course and lack of sputum production and wealth of extrapulmonary symptoms. Chronic Mycoplasma infections have been implicated in the pathogenesis of rheumatoid arthritis and other rheumatological diseases.
Mycoplasma atypical pneumonia can be complicated by Stevens–Johnson syndrome, autoimmune hemolytic anemia, cardiovascular diseases, encephalitis, or Guillain–Barré syndrome.
Diagnosis
M. pneumoniae infections can be differentiated from other types of pneumonia by the relatively slow progression of symptoms. A positive blood test for cold-hemagglutinins in 50-70% of patients after 10 days of infection (cold-hemagglutinin-test should be used with caution or not at all, since 50% of the tests are false-positive), lack of bacteria in a Gram-stained sputum sample, and a lack of growth on blood agar.
PCR has also been used.[1]
Treatment
While antibiotics with activity specifically against M. pneumoniae are often used (e.g., erythromycin, doxycycline), it is unclear if these result in greater benefit than using antibiotics without specific activity against this organism in those with an infection acquired in the community.[2]
References
- ^ Waris ME, Toikka P, Saarinen T, et al. (November 1998). "Diagnosis of Mycoplasma pneumoniae pneumonia in children". J. Clin. Microbiol. 36 (11): 3155–9. PMC 105292. PMID 9774556.
- ^ Biondi, E; McCulloh, R; Alverson, B; Klein, A; Dixon, A (Jun 2014). "Treatment of mycoplasma pneumonia: a systematic review.". Pediatrics. 133 (6): 1081–90. doi:10.1542/peds.2013-3729. PMID 24864174.
- Firmicutes (low-G+C) Infectious diseases
- Bacterial diseases: G+
- primarily A00–A79, 001–041, 080–109
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| Bacilli |
Lactobacillales
(Cat-) |
| Streptococcus |
| α |
| optochin susceptible: |
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| optochin resistant: |
- Viridans streptococci: S. mitis
- S. mutans
- S. oralis
- S. sanguinis
- S. sobrinus
- milleri group
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|
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| β |
| A: |
- bacitracin susceptible: S. pyogenes
- Group A streptococcal infection
- Streptococcal pharyngitis
- Scarlet fever
- Erysipelas
- Rheumatic fever
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| B: |
- bacitracin resistant, CAMP test+: S. agalactiae
- Group B streptococcal infection
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| ungrouped: |
- Streptococcus iniae
- Cutaneous Streptococcus iniae infection
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| γ |
- D
- BEA+: Streptococcus bovis
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| Enterococcus |
- BEA+: Enterococcus faecalis
- Enterococcus faecium
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Bacillales
(Cat+) |
| Staphylococcus |
| Cg+: |
- S. aureus
- Staphylococcal scalded skin syndrome
- Toxic shock syndrome
- MRSA
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| Cg-: |
- novobiocin susceptible
- novobiocin resistant
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| Bacillus |
- Bacillus anthracis
- Bacillus cereus
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| Listeria |
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| Clostridia |
| Clostridium (spore-forming) |
| motile: |
- Clostridium difficile
- Clostridium botulinum
- Clostridium tetani
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| nonmotile: |
- Clostridium perfringens
- Gas gangrene
- Clostridial necrotizing enteritis
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| Peptostreptococcus (non-spore forming) |
- Peptostreptococcus magnus
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| Mollicutes |
| Mycoplasmataceae |
- Ureaplasma urealyticum
- Mycoplasma genitalium
- Mycoplasma pneumoniae
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| Anaeroplasmatales |
- Erysipelothrix rhusiopathiae
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Diseases of the respiratory system (J, 460–519)
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Upper RT
(including URTIs,
common cold) |
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Head
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- sinuses
- Sinusitis
- nose
- Rhinitis
- Vasomotor rhinitis
- Atrophic rhinitis
- Hay fever
- Nasal polyp
- Rhinorrhea
- nasal septum
- Nasal septum deviation
- Nasal septum perforation
- Nasal septal hematoma
- tonsil
- Tonsillitis
- Adenoid hypertrophy
- Peritonsillar abscess
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Neck
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- pharynx
- Pharyngitis
- Strep throat
- Laryngopharyngeal reflux (LPR)
- Retropharyngeal abscess
- larynx
- Croup
- Laryngomalacia
- Laryngeal cyst
- Laryngitis
- Laryngopharyngeal reflux (LPR)
- Laryngospasm
- vocal folds
- Laryngopharyngeal reflux (LPR)
- Vocal fold nodule
- Vocal cord paresis
- Vocal cord dysfunction
- epiglottis
- Epiglottitis
- trachea
- Tracheitis
- Tracheal stenosis
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Lower RT/lung disease
(including LRTIs) |
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Bronchial/
obstructive
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- acute
- Acute bronchitis
- chronic
- COPD
- Chronic bronchitis
- Acute exacerbations of chronic bronchitis
- Acute exacerbation of COPD
- Emphysema)
- Asthma (Status asthmaticus
- Aspirin-induced
- Exercise-induced
- Bronchiectasis
- unspecified
- Bronchitis
- Bronchiolitis
- Bronchiolitis obliterans
- Diffuse panbronchiolitis
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Interstitial/
restrictive
(fibrosis) |
External agents/
occupational
lung disease |
- Pneumoconiosis
- Asbestosis
- Baritosis
- Bauxite fibrosis
- Berylliosis
- Caplan's syndrome
- Chalicosis
- Coalworker's pneumoconiosis
- Siderosis
- Silicosis
- Talcosis
- Byssinosis
- Hypersensitivity pneumonitis
- Bagassosis
- Bird fancier's lung
- Farmer's lung
- Lycoperdonosis
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Other
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- ARDS
- Pulmonary edema
- Löffler's syndrome/Eosinophilic pneumonia
- Respiratory hypersensitivity
- Allergic bronchopulmonary aspergillosis
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Sarcoidosis
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Obstructive or
restrictive
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Pneumonia/
pneumonitis
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By pathogen
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- Viral
- Bacterial
- Atypical bacterial
- Mycoplasma
- Legionnaires' disease
- Chlamydiae
- Fungal
- Parasitic
- noninfectious
- Chemical/Mendelson's syndrome
- Aspiration/Lipid
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By vector/route
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- Community-acquired
- Healthcare-associated
- Hospital-acquired
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By distribution
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IIP
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Other
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- Atelectasis
- circulatory
- Pulmonary hypertension
- Pulmonary embolism
- Lung abscess
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Pleural cavity/
mediastinum |
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Pleural disease
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- Pneumothorax/Hemopneumothorax
- Pleural effusion
- Hemothorax
- Hydrothorax
- Chylothorax
- Empyema/pyothorax
- Malignant
- Fibrothorax
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Mediastinal disease
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- Mediastinitis
- Mediastinal emphysema
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| Other/general |
- Respiratory failure
- Influenza
- SARS
- Idiopathic pulmonary haemosiderosis
- Pulmonary alveolar proteinosis
|
UpToDate Contents
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English Journal
- The aetiology and antibiotic management of community-acquired pneumonia in adults in Europe: a literature review.
- Torres A1, Blasi F, Peetermans WE, Viegi G, Welte T.
- European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology.Eur J Clin Microbiol Infect Dis.2014 Jul;33(7):1065-79. doi: 10.1007/s10096-014-2067-1. Epub 2014 Feb 15.
- The purpose of this paper was to generate up-to-date information on the aetiology of community-acquired pneumonia (CAP) and its antibiotic management in adults across Europe. Structured searches of PubMed identified information on the aetiology of CAP and its antibiotic management in individuals age
- PMID 24532008
- Immune responses of a chimaeric protein vaccine containing Mycoplasma hyopneumoniae antigens and LTB against experimental M. hyopneumoniae infection in pigs.
- Marchioro SB1, Sácristan RD2, Michiels A2, Haesebrouck F2, Conceição FR3, Dellagostin OA3, Maes D2.
- Vaccine.Vaccine.2014 Jun 5. pii: S0264-410X(14)00758-0. doi: 10.1016/j.vaccine.2014.05.072. [Epub ahead of print]
- A recombinant chimaeric protein containing three Mycoplasma hyopneumoniae antigens (C-terminal portion of P97, heat shock protein P42, and NrdF) fused to an adjuvant, the B subunit of heat-labile enterotoxin of Escherichia coli (LTB), was used to immunize pigs against enzootic pneumonia. The systemi
- PMID 24909331
- The bacterial aetiology of adult community-acquired pneumonia in Asia: a systematic review.
- Peto L1, Nadjm B2, Horby P1, Ngan TT3, van Doorn R1, Kinh NV3, Wertheim HF1.
- Transactions of the Royal Society of Tropical Medicine and Hygiene.Trans R Soc Trop Med Hyg.2014 Jun;108(6):326-337. Epub 2014 Apr 29.
- BACKGROUND: Community-acquired pneumonia (CAP) is a major cause of adult mortality in Asia. Appropriate empirical treatment depends on knowledge of the pathogens commonly responsible. However, assessing the aetiological significance of identified organisms is often difficult, particularly with sputu
- PMID 24781376
Japanese Journal
- 研究・症例 肺門・縦隔リンパ節腫大および横紋筋融解症を伴ったマイコプラズマ肺炎の1例
- Ameliorative effects of Qingfei Tongluo formula on experimental mycoplasmal pneumonia in mice
Related Links
- Baum SG. Mycoplasma pneumonia and atypical pneumonia. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier ...
- Mycoplasma pneumoniae is a common cause of community-acquired pneumonia (CAP), and the disease usually has a prolonged, gradual onset. M pneumoniae was first isolated in cattle with pleuropneumonia in 1898.
Related Pictures
★リンクテーブル★
[★]
- 英
- mycoplasma pneumonia
- 同
- 寒冷凝集反応陽性肺炎 coldagglutinin-positive pneumonia、オリンピック病 Olympic disease、イートン因子肺炎
- 関
- マイコプラズマ、非定型肺炎。Mycoplasma pneumoniae
概念
- マイコプラズマは人工培地上で発育できる最小の微生物で、一般細菌と異なり細胞壁を欠く。
- Mycoplasma pneumoniaeによる肺炎
- 4年に1度オリンピックの開催年に多発する傾向がみられたためオリンピック病とも呼ばれたが、近年この傾向はあまりみられない。
- 若年者に多く、強い咳嗽と高熱が特徴である。
疫学
- 健康な小児や若年成人の肺炎でよく見られる。
- 好発年齢：5-25歳
潜伏期
感染経路
症状
- 初期には乾性咳嗽
- 発熱、激しい咳嗽、結膜充血、頭痛などを呈する。
- 喀痰が無いことが多い。
検査
- 白血球：増加することは少ない。80～90%の症例で10000/μL以下
- CRP：軽度上昇にとどまる。
- 血中寒冷凝集素価：陽性(256-512倍以上)。約50%の症例で上昇。
- 胸部XP：下肺野に陰影が多い。
- CT：非定型肺炎の陰影を呈する。間質性の炎症像を呈し網状影が主体で、次いで炎症が肺胞領域に及ぶと斑状影となり、いわゆる細葉性の陰影を示す。
診断
- CF法はIgGクラスの抗体を検出
- PA法はIgMクラスの抗体を検出
- たいていの迅速検査ではIgM抗体を検出している。
- 急性期と回復期(2～4週以降)のペア血清を用いて、特異抗体価が4倍以上の上昇を示す
治療
- テトラサイクリン、マクロライド系薬剤が有効。
- ペニシリン系抗菌薬、セフェム系抗菌薬、カルバペネム系抗菌薬は無効。
鑑別
国試
[★]
マイコプラズマ肺炎
