Pneumonia of Unknown Etiology Among Adolescents: Consider Mycoplasma pneumoniae in Diagnostic Testing

PNEUMONIA ADVISORY FOR HEALTH CARE PROVIDERS

November 8, 2024

On November 1, Central District Health was notified of several reports of mild pneumonia among adolescents and an adult with illness onsets during the last month. Clinical diagnosis was based on chest X-ray findings. Laboratory testing included Streptokokkus pneumoniae, influenza, and COVID-19 but an etiologic agent or agents has not been identified.

Preliminary investigation suggests emergency department and urgent care visits with a chief complaint or discharge diagnosis of pneumonia have increased in October among children in the community in comparison with prior months.

Nationwide, Mycoplasma pneumoniae infections have increased. Health care providers are requested to consider M. pneumoniae as a cause of pneumonia in addition to other potential causes, particularly in young children, and test when indicated. Nucleic acid amplification tests, especially by using multiplex respiratory panels, on throat and nasopharyngeal swabs are the preferred method of diagnostic testing.

M. pneumoniae are resistant to certain antibiotics (e.g., beta-lactams such as amoxicillin) commonly used to treat other kinds of bacterial pneumonia. Macrolides (e.g., azithromycin) are the first-line antibiotic treatment for M. pneumoniae infection. Patients with community-acquired pneumonia who aren’t clinically improving on antibiotics known to be ineffective against M. pneumoniae may benefit from a regimen that covers M. pneumoniae.

Healthcare providers are reminded that pertussis cases remain elevated in the Treasure Valley. Statewide, RSV is increasing although RSV season has not been officially declared in Idaho this fall.

Report unusual clusters or outbreaks of respiratory illnesses to Central District Health at (208) 327-8625.

Ressourcen

CDC: Mycoplasma pneumoniae infections have been increasing. https://www.cdc.gov/ncird/whats-new/mycoplasma-pneumoniae-infections-have-been-increasing.html

Press release on pertussis increase in the Treasure Valley: https://cdh.idaho.gov/local-health-districts-warn-about-sharp-increase-in-pertussis-cases/

Respiratory virus trackers: https://www.gethealthy.dhw.idaho.gov/infectious-disease-idaho (Idaho) and https://www.cdc.gov/nrevss/php/dashboard/index.html (United States).

Please contact Sarah Wright, Central District Health, (208) 321-2245, if you have any questions.