Clinical findings, nonmicrobiologic laboratory tests, and CXR are not useful in distinguishing M. pneumoniae pneumonia from pneumonia of other etiologies.
- Acute M. pneumoniae infection can be diagnosed by PCR analysis of respiratory tract secretions, which is 65-90% sensitive and 90-100% specific.
- M. pneumoniae culture (which requires special medium) is not recommended for routine diagnosis because its sensitivity is ≤60% and growth of the organism can take weeks.
- Serologic testing for IgM and IgG antibodies to M. pneumoniae requires acute- and convalescent-phase samples and is therefore less useful for diagnosis of active infections. Moreover, IgM antibodies to M. pneumoniae can persist for up to 1 year after acute infection.
- Measurement of cold agglutinin titers is no longer recommended for the diagnosis of M. pneumoniae infection because the findings are nonspecific.
Treatment: M. Pneumoniae Infections - Antibiotic options include macrolides (azithromycin, 500 mg PO for 1 day followed by 250 mg for 4 days), tetracyclines (doxycycline, 100 mg PO bid for 10-14 days), and respiratory fluoroquinolones (levofloxacin, 500-750 mg PO qd for 10-14 days).
- Ciprofloxacin and ofloxacin are not recommended because of their high minimal inhibitory concentrations against M. pneumoniae.
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