Highlights & Basics
- Mycoplasma pneumoniae causes community-acquired pneumonia and upper respiratory illness.
- Infection is often seen in close community settings, such as schools, army bases, colleges, nursing homes, and hospitals.
- Diagnosis of infection is usually made clinically; nucleic acid amplification tests (e.g., polymerase chain reaction), culture, or serology are required in hospitalized patients and those with severe disease to confirm M pneumoniae as the infecting pathogen. Limitations of serology include the possibility of false-positive results.
- A macrolide or tetracycline antibiotic is usually effective as first-line treatment of mycoplasma infections in both uncomplicated and more severe community-acquired pneumonia.
- Fluoroquinolones may be effective as second-line treatment if previous antibiotics fail.
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Citations
British Thoracic Society. BTS guidelines for the management of community acquired pneumonia in adults: update 2009. Jan 2015 [internet publication].[Full Text]
Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-67.[Abstract][Full Text]
1. Spuesens EB, Fraaij PL, Visser EG, et al. Carriage of Mycoplasma pneumoniae in the upper respiratory tract of symptomatic and asymptomatic children: an observational study. PLoS Med. 2013;10:e1001444.[Abstract][Full Text]
2. Narita M. Classification of extrapulmonary manifestations due to Mycoplasma pneumoniae infection on the basis of possible pathogenesis. Front Microbiol. 2016;7:23.[Abstract][Full Text]
3. Waites KB, Talkington DF. Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev. 2004 Oct;17(4):697-728.[Abstract][Full Text]
4. Lang Houser M, Mancuso JB, Gudjonsson JE, et al. Mycoplasma pneumoniae-induced rash and mucositis: clinicopathologic characterization of 11 cases. J Cutan Pathol. 2026 Mar;53(3):276-83.[Abstract][Full Text]
5. Atkinson TP, Balish MF, Waites KB. Epidemiology, clinical manifestations, pathogenesis and laboratory detection of Mycoplasma pneumoniae infections. FEMS Microbiol Rev. 2008 Nov;32(6):956-73.[Abstract]
6. Pereira C, Scortegagna F, Corrêa DG, et al. Neurological complications of Mycoplasma pneumoniae infection. Rev Soc Bras Med Trop. 2026;59:e03422025.[Abstract][Full Text]
7. Chevalier K, Holub M, Palich R, et al. Cold agglutinin syndrome secondary to Mycoplasma pneumoniae infection in adults: results from a Large French Observational Study (MyCOLD Study). Am J Hematol. 2025 Sep;100(9):1557-65.[Abstract][Full Text]
8. British Thoracic Society. BTS guidelines for the management of community acquired pneumonia in adults: update 2009. Jan 2015 [internet publication].[Full Text]
9. Kim KW, Sung JJ, Tchah H, et al. Hepatitis associated with Mycoplasma pneumoniae infection in Korean children: a prospective study. Korean J Pediatr. 2015 Jun;58(6):211-7.[Abstract][Full Text]
10. Kurkela S, Puolakkainen M, Hokynar K, et al. Mycoplasma pneumoniae outbreak, Southeastern Finland, 2017-2018: molecular epidemiology and laboratory diagnostic lessons. Eur J Clin Microbiol Infect Dis. 2019 Oct;38(10):1867-71.[Abstract][Full Text]
11. Almendares OM, Fritschmann B, Selvarangan R, et al. Notes from the field: school-based surveillance of Mycoplasma pneumoniae trends and impact on school attendance by students and staff members - Missouri, Fall 2024. MMWR Morb Mortal Wkly Rep. 2024 Dec 19;73(50):1144-6.[Abstract][Full Text]
12. Centers for Disease Control and Prevention. Mycoplasma pneumoniae infection: causes and how it spreads. Oct 2024 [internet publication].[Full Text]
13. Kutty PK, Jain S, Taylor TH, et al. Mycoplasma pneumoniae among children hospitalized with community-acquired pneumonia. Clin Infect Dis. 2019 Jan 1;68(1):5-12.[Abstract][Full Text]
14. Waller JL, Diaz MH, Petrone BL, et al. Detection and characterization of Mycoplasma pneumoniae during an outbreak of respiratory illness at a university. J Clin Microbiol. 2014 Mar;52(3):849-53.[Abstract][Full Text]
15. Feikin DR, Moroney JF, Talkington DF, et al. An outbreak of acute respiratory disease caused by Mycoplasma pneumoniae and adenovirus at a federal service training academy: new implications from an old scenario. Clin Infect Dis. 1999;29:1545-50.[Abstract]
16. Diaz MH, Hersh AL, Olson J, et al. Mycoplasma pneumoniae Infections in hospitalized children - United States, 2018-2024. MMWR Morb Mortal Wkly Rep. 2025 Jun 26;74(23):394-400.[Abstract][Full Text]
17. Xu YC, Zhu LJ, Xu D, et al. Epidemiological characteristics and meteorological factors of childhood Mycoplasma pneumoniae pneumonia in Hangzhou. World J Pediatr. 2011;7:240-4.[Abstract]
18. Gadsby NJ, Reynolds AJ, McMenamin J, et al. Increased reports of Mycoplasma pneumoniae from laboratories in Scotland in 2010 and 2011 - impact of the epidemic in infants. Euro Surveill. 2012;17:pii:20110.[Abstract][Full Text]
19. Chalker V, Stocki T, Litt D, et al. Increased detection of Mycoplasma pneumoniae infection in children in England and Wales, October 2011 to January 2012. Euro Surveill. 2012;17:pii:20081.[Abstract][Full Text]
20. Pereyre S, Charron A, Hidalgo-Grass C, et al. The spread of Mycoplasma pneumoniae is polyclonal in both an endemic setting in France and in an epidemic setting in Israel. PLoS One. 2012;7:38585.[Abstract][Full Text]
21. Beeton ML, Zhang XS, Uldum SA, et al. Mycoplasma pneumoniae infections, 11 countries in Europe and Israel, 2011 to 2016. Euro Surveill. 2020 Jan;25(2):1900112.[Abstract][Full Text]
22. Nir-Paz R, Abutbul A, Moses AE, et al. Ongoing epidemic of Mycoplasma pneumoniae infection in Jerusalem, Israel, 2010 to 2012. Euro Surveill. 2012;17:pii:20095.[Abstract][Full Text]
23. Uldum SA, Bangsborg JM, Gahrn-Hansen B, et al. Epidemic of Mycoplasma pneumoniae infection in Denmark, 2010 and 2011. Euro Surveill. 2012;17:pii:20073.[Abstract][Full Text]
24. Jain S, Williams DJ, Arnold SR, et al. Community-acquired pneumonia requiring hospitalization among US children. N Engl J Med. 2015;372:835-45.[Abstract][Full Text]
25. Sharplin L, Goyal V. Mycoplasma pneumoniae respiratory tract infections in children: when and how to diagnose and treat. Breathe (Sheff). 2025 Oct;21(4):250046.[Abstract][Full Text]
26. Centers for Disease Control and Prevention. Mycoplasma pneumoniae infections have been increasing. Oct 2024 [internet publication].[Full Text]
27. Brown RJ, Nguipdop-Djomo P, Zhao H, et al. Mycoplasma pneumoniae epidemiology in England and Wales: a national perspective. Front Microbiol. 2016;7:157.[Abstract][Full Text]
28. ESGMAC MAPS study group. Global spatiotemporal dynamics of Mycoplasma pneumoniae re-emergence after COVID-19 pandemic restrictions: an epidemiological and transmission modelling study. Lancet Microbe. 2025 Apr;6(4):101019.[Abstract][Full Text]
29. Edens C, Clopper BR, DeVies J, et al. Notes from the field: reemergence of Mycoplasma pneumoniae infections in children and adolescents after the COVID-19 pandemic, United States, 2018-2024. MMWR Morb Mortal Wkly Rep. 2024 Feb 22;73(7):149-51.[Abstract][Full Text]
30. Ferguson GD, Gadsby NJ, Henderson SS, et al. Clinical outcomes and macrolide resistance in Mycoplasma pneumoniae infection in Scotland, UK. J Med Microbiol. 2013;62:1876-82.[Abstract]
31. Kim K, Jung S, Kim M, et al. Global trends in the proportion of macrolide-resistant Mycoplasma pneumoniae infections: a systematic review and meta-analysis. JAMA Netw Open. 2022 Jul 1;5(7):e2220949.[Abstract][Full Text]
32. Meyer Sauteur PM, European Society of Clinical Microbiology and Infectious Diseases Study Group for Mycoplasma and Chlamydia Infections (ESGMAC) Mycoplasma pneumoniae Surveillance (MAPS) study group. Mycoplasma pneumoniae: re-emergence and beyond. Lancet Microbe. 2025 Nov;6(11):101191.[Abstract][Full Text]
33. Steinberg P, White RJ, Fuld SL, et al. Ecology of Mycoplasma pneumoniae infections in marine recruits at Parris Island, South Carolina. Am J Epidemiol. 1969;89:62-73.[Abstract]
34. Wan GH, Huang CG, Huang YC, et al. Surveillance of airborne adenovirus and Mycoplasma pneumoniae in a hospital pediatric department. PLoS One. 2012;7:e33974.[Abstract][Full Text]
35. Johnson SM, Bruckner F, Collins D. Distribution of Mycoplasma pneumoniae and Mycoplasma salivarium in the synovial fluid of arthritis patients. J Clin Microbiol. 2007;45:953-7.[Abstract][Full Text]
36. Daxboeck F, Khanakah G, Bauer C, et al. Detection of Mycoplasma pneumoniae in serum specimens from patients with Mycoplasma pneumonia by PCR. Int J Med Microbiol. 2005;295:279-85.[Abstract]
37. Saraya T, Kurai D, Nakagaki K, et al. Novel aspects on the pathogenesis of Mycoplasma pneumoniae pneumonia and therapeutic implications. Front Microbiol. 2014;5:410.[Abstract][Full Text]
38. Johnston SL, Martin RJ. Chlamydophila pneumoniae and Mycoplasma pneumoniae: a role in asthma pathogenesis? Am J Respir Crit Care Med. 2005 Nov 1;172(9):1078-89.[Abstract]
39. Katz B, Waites K. Emerging intracellular bacterial infections. Clin Lab Med. 2004;24:627-49.[Abstract]
40. Zhang X, Han MN, Dong JH, et al. Outbreak of Mycoplasma pneumoniae at a military academy. Mil Med Res. 2020 Dec 3;7(1):60.[Abstract][Full Text]
41. Klement E, Talkington DF, Wasserzug O, et al. Identification of risk factors for infection in an outbreak of Mycoplasma pneumoniae respiratory tract disease. Clin Infect Dis. 2006;43:1239-45.[Abstract]
42. Arcavi L, Benowitz NL. Cigarette smoking and infection. Arch Intern Med. 2004;164:2206-16.[Abstract]
43. Poddighe D, Demirkaya E, Sazonov V, et al. Mycoplasma pneumoniae infections and primary immune deficiencies. Int J Clin Pract. 2022;2022:6343818.[Abstract][Full Text]
44. Goycochea-Valdivia WA, Ares Alvarez J, Conejo Fernández AJ, et al. Position statement of the Spanish Society of Paediatric Infectious diseases on the diagnosis and treatment of Mycoplasma pneumoniae infection. An Pediatr (Engl Ed). 2024 Jul;101(1):46-57.[Abstract][Full Text]
45. Neumayr L, Lennette E, Kelly D, et al. Mycoplasma disease and acute chest syndrome in sickle cell disease. Pediatrics. 2003;112:87-95.[Abstract]
46. Klausner JD, Passaro D, Rosenberg J, et al. Enhanced control of an outbreak of Mycoplasma pneumoniae pneumonia with azithromycin prophylaxis. J Infect Dis. 1998;177:161-6.[Abstract][Full Text]
47. Hyde TB, Gilbert M, Schwartz SB. Azithromycin prophylaxis during a hospital outbreak of Mycoplasma pneumoniae pneumonia. J Infect Dis. 2001;183:907-12.[Abstract][Full Text]
48. Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-67.[Abstract][Full Text]
49. Mukae H, Iwanaga N, Horita N, et al. The JRS guideline for the management of pneumonia in adults 2024. Respir Investig. 2025 Sep;63(5):811-28.[Abstract][Full Text]
50. Miller JM, Binnicker MJ, Campbell S, et al. Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM). Clin Infect Dis. 2024 Mar 5;ciae104.[Abstract][Full Text]
51. Centers for Disease Control and Prevention. Laboratory Testing for Mycoplasma pneumoniae. Dec 2023 [internet publication].[Full Text]
52. Centers for Disease Control and Prevention. Submitting specimens for Mycoplasma pneumoniae testing. Oct 2024 [internet publication].[Full Text]
53. Leber AL, Oyeniran SJ, Wang H. Reduced sensitivity of a multiplex commercial respiratory panel for detection of Mycoplasma pneumoniae is due to specimen type. J Clin Microbiol. 2024 Oct 16;62(10):e0113924.[Abstract][Full Text]
54. Kakuya F, Kinebuchi T, Okubo H, et al. Comparison of oropharyngeal and nasopharyngeal swab specimens for the detection of Mycoplasma pneumoniae in children with lower respiratory tract infection. J Pediatr. 2017 Oct;189:218-21.[Abstract]
55. Waites KB, Xiao L, Liu Y, et al. Mycoplasma pneumoniae from the respiratory tract and beyond. Clin Microbiol Rev. 2017 Jul;30(3):747-809.[Abstract][Full Text]
56. Lee WJ, Huang EY, Tsai CM, et al. Role of serum Mycoplasma pneumoniae IgA, IgM, and IgG in the diagnosis of Mycoplasma pneumoniae-related pneumonia in school-age children and adolescents. Clin Vaccine Immunol. 2017 Jan;24(1):e00471-16.[Abstract][Full Text]
57. Choo S, Kim SH, Lee E. Clinical significance of Mycoplasma pneumoniae specific IgM titer in children hospitalized with Mycoplasma pneumoniae pneumonia. BMC Infect Dis. 2022 May 16;22(1):470.[Abstract][Full Text]
58. Leal SM Jr, Totten AH, Xiao L, et al. Evaluation of commercial molecular diagnostic methods for detection and determination of macrolide resistance in Mycoplasma pneumoniae. J Clin Microbiol. 2020 May 26;58(6):e00242-20.[Abstract][Full Text]
59. Saraya T. Mycoplasma pneumoniae infection: basics. J Gen Fam Med. 2017 Jun;18(3):118-25.[Abstract][Full Text]
60. O'Driscoll BR, Howard LS, Earis J, et al. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax. 2017 Jun;72(1 suppl):ii1-90.[Abstract][Full Text]
61. Jones BE, Ramirez JA, Oren E, et al. Diagnosis and management of community-acquired pneumonia: an official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2026 Jan 1;212(1):24-44.[Abstract][Full Text]
62. Francavilla M, Orlandi A, Camporesi A, et al. Lung ultrasound findings in pediatric Mcoplasma pneumoniae pneumonia: a prospective multicenter pilot study. Children (Basel). 2025 Dec 8;12(12):1669.[Abstract][Full Text]
63. Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997 Jan 23;336(4):243-50.[Abstract][Full Text]
64. Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58:377-82.[Abstract][Full Text]
65. Okada T, Morozumi M, Tajima T, et al. Rapid effectiveness of minocycline or doxycycline against macrolide-resistant Mycoplasma pneumoniae infection in a 2011 outbreak among Japanese children. Clin Infect Dis. 2012;55:1642-9.[Abstract]
66. Kawai Y, Miyashita N, Kubo M, et al. Therapeutic efficacy of macrolides, minocycline, and tosufloxacin against macrolide-resistant Mycoplasma pneumoniae pneumonia in pediatric patients. Antimicrob Agents Chemother. 2013;57:2252-8.[Abstract]
67. Rusu A, Munteanu AC, Arbănași EM, et al. Overview of side-effects of antibacterial fluoroquinolones: new drugs versus old drugs, a step forward in the safety profile? Pharmaceutics. 2023 Mar 1;15(3):804.[Abstract][Full Text]
68. Mikasa K, Aoki N, Aoki Y, et al. JAID/JSC guidelines for the treatment of respiratory infectious diseases: the Japanese Association for Infectious Diseases/Japanese Society of Chemotherapy - the JAID/JSC guide to clinical management of infectious disease/guideline-preparing committee respiratory infectious disease WG. J Infect Chemother. 2016 Jul;22(7 suppl):S1-65.[Abstract][Full Text]
69. The Committee of Japanese Society of Mycoplasmology. Guiding principles for treating Mycoplasma pneumoniae pneumonia. May 2014 [internet publication].[Full Text]
70. File TM, Goldberg L, Das A, et al. Efficacy and safety of intravenous-to-oral lefamulin, a pleuromutilin antibiotic, for the treatment of community-acquired bacterial pneumonia: the phase III lefamulin evaluation against pneumonia (LEAP 1) trial. Clin Infect Dis. 2019 Nov 13;69(11):1856-67.[Abstract][Full Text]
71. Alexander E, Goldberg L, Das AF, et al. Oral lefamulin vs moxifloxacin for early clinical response among adults with community-acquired bacterial pneumonia: the LEAP 2 randomized clinical trial. JAMA. 2019 Sep 27;322(17):1661-71.[Abstract][Full Text]
72. Horcajada JP, Salata RA, Álvarez-Sala R, et al. A phase 3 study to compare delafloxacin with moxifloxacin for the treatment of adults with community-acquired bacterial pneumonia (DEFINE-CABP). Open Forum Infect Dis. 2020 Jan;7(1):ofz514.[Abstract][Full Text]
73. Stets R, Popescu M, Gonong JR, et al. Omadacycline for community-acquired bacterial pneumonia. N Engl J Med. 2019 Feb 7;380(6):517-27.[Abstract][Full Text]
74. Yuan J, Mo B, Ma Z, et al. Safety and efficacy of oral nemonoxacin versus levofloxacin in treatment of community-acquired pneumonia: a phase 3, multicenter, randomized, double-blind, double-dummy, active-controlled, non-inferiority trial. J Microbiol Immunol Infect. 2019 Feb;52(1):35-44.[Abstract][Full Text]
75. National Institute for Health and Care Excellence. Pneumonia (community-acquired): antimicrobial prescribing. NICE guideline NG138. Sep 2019 [internet publication].[Full Text]
76. Walter ND, Grant GB, Bandy U, et al. Community outbreak of Mycoplasma pneumoniae infection: school-based cluster of neurologic disease associated with household transmission of respiratory illness. J Infect Dis. 2008;198:1365-74.[Abstract]
77. Kannan TR, Hardy RD, Coalson JJ, et al. Fatal outcomes in family transmission of Mycoplasma pneumoniae. Clin Infect Dis. 2012;54:225-31.[Abstract]
78. Mélé N, Turc G. Stroke associated with recent Mycoplasma pneumoniae infection: a systematic review of clinical features and presumed pathophysiological mechanisms. Front Neurol. 2018;9:1109.[Abstract][Full Text]
79. Yoosuf FT, Al Hariri B, Illahi MN, et al. Mycoplasma-pneumonia-induced Stevens-Johnson syndrome in an adult: a case report. J Med Case Rep. 2025 Feb 26;19(1):74.[Abstract][Full Text]
80. Rasul S, Farhat F, Endailalu Y, et al. Mycoplasma pneumoniae-induced-Stevens Johnson syndrome: rare occurrence in an adult patient. Case Rep Med. 2012;2012:430490.[Abstract][Full Text]
81. Scerpella EG, Whimbey EE, Champlin RE, et al. Pericarditis associated with Legionnaires' disease in a bone marrow transplant recipient. Clin Infect Dis. 1994 Dec;19(6):1168-70.[Abstract]
82. Khoury T, Abu Rmeileh A, Kornspan JD, et al. Mycoplasma pneumoniae pneumonia associated with methemoglobinemia and anemia: an overlooked association? Open Forum Infect Dis. 2015;2:ofv022.[Abstract][Full Text]
83. Grullich C, Baumert TF, Blum HE. Acute Mycoplasma pneumoniae infection presenting as cholestatic hepatitis. J Clin Microbiol. 2003;41:514-5.[Abstract][Full Text]
84. Romero-Gomez M, Otero MA, Sanchez-Munoz D, et al. Acute hepatitis due to Mycoplasma pneumoniae infection without lung involvement in adult patients. J Hepatol. 2006;44:827-8.[Abstract]
85. Shuvy M, Rav-Acha M, Izhar U, et al. Massive empyema caused by Mycoplasma pneumoniae in an adult: a case report. BMC Infect Dis. 2006;6:18.[Abstract]
86. Narita M, Tanaka H. Two distinct patterns of pleural effusions caused by Mycoplasma pneumoniae infection. Pediatr Infect Dis J. 2004;23:1069.[Abstract]
