|A.||Start the patient on azithromycin|
Admit the patient for IV fluoroquinolones
Perform a PPD test on this patient
Perform a CT scan
Ans. A. Start the patient on azithromycin
Mycoplasma pneumoniae is responsible for the vast majority of atypical respiratory infections. However, only about 10% of patients who acquire mycoplasma will develop pneumonia. The infection can occur all year round, and outbreaks in small communities are common (e.g., schools, homes). This patient can be managed on an outpatient basis and does not require admission.
First-line treatment is the macrolide family of antibiotics, although resistance is emerging. Azithromycin is the most common and is available in intravenous and oral formulations; the short treatment course of just 5 days increases patient compliance.
Once the organism is acquired, the symptoms may take 4-20 days to appear and include malaise, cough, myalgia, and sore throat. The cough is often dry and worse at night. Most cases of Mycoplasma pneumoniae infection are mild and resolve on their own. Mycoplasma can also cause a variety of extrapulmonary symptoms like erythema nodosum, urticaria, erythema multiforme, aseptic meningitis, Guillain Barre syndrome, and cerebral ataxia.