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Recurrent pneumonia and encephalitis due to Mycoplasma pneumoniae.

Recurrent Mycoplasma pneumoniae encephalitis in a young man is reported. The patient appeared not to be immunodeficient and despite the presence of a focal inflammatory brain lesion with a predominance of polymorphonuclear cells no direct evidence of inent in M. pneumoniae respiratory tract infection still is unknown the case strongly indicates that certain individuals are somehow predisposed to such complications. The case also illustrates that CNS complications may occur even during a mild mycoplasma respiratory tract infection and that the radiological findings can mimic cerebral haemorrhage or abscess necessitating neurosurgical exploration.

Adult

Motility of Mycoplasma pneumoniae.

Cell of Mycoplasma pneumoniae FH gliding on a glass surface in liquid medium were examined by microscopic observation and quantitatively by microcinematography (30 frames per min). Comparisons were made only within the individual experiments. The cells moved in an irregular pattern with numerous narrow bends and circles. They never changed their leading end. The average speed (without pauses) was relatively constant between o.2 and 0.5 mum/s. The maximum speed was about 1.5 to 2.0 mum/s. The movements were interrupted by resting periods of different lengths and frequency. Temperature, viscosity, pH, and the presence of yeast extract in the medium influenced the motility significantly; changes in glucose, calcium ions, and serum content were less effective. The movements were affected by iodoacetate, p-mercuribenzoate, and mitomycin C at inhibitory or subinhibitory concentrations. Sodium fluoride, sodium cyanide, dinitrophenol, chloramphenicol, puromycin, cholchicin, and cytochalasin B at minimal inhibitory concentrations did not affect motility. The movements were effectively inhibited by anti-M. pneumoniae antiserum. Studies with absorbed antiserum suggested that the surface components involved in motility are heat labile. The gliding of M. pneumoniae cells required an intact energy metabolism and the proteins involved seemed to have a low turnover.

Anti-Bacterial Agents

Autoimmune reactions associated with Mycoplasma pneumoniae infection.

Patients with Mycoplasma pneumoniae infection often develop various autoantibodies including cold agglutinins, cold antibodies reacting with lymphocytes, antibodies against various tissue antigens, for instance brain and lung and smooth muscle antibodies. Various mechanisms that may be responsible for the induction of these autoimmune responses and the possible pathogenicity of these autoantibodies are discussed.

Agglutinins

[Illness due to mycoplasma pneumoniae in childhood (author's transl)].

Mycoplasma pneumoniae infection could be found in 16 from 92 children treated for respiratory disease in a Hungarian hospital. It was verified by growth inhibition test or by culturing germs from bronchial secretions. Seroology proved to be more effective than culture for identification. Illnesses due to Mycoplasma pneumoniae seem to be more frequent in the age group 0--3 years in Hungary than they are in western countries in the same age group. The authors assume that this high frequency is caused because children in this country are earlier admitted to community facilities (crèche, kindergarten, hospital) than in western countries. Therefore mycoplasma pneumoniae infection must be paid attention to also in acute respiratory diseases in the first 3 years of life, when children are admitted to community facilities.

Adolescent

Adherence of erythrocytes to Mycoplasma pneumoniae.

The human pathogen Mycoplasma pneumoniae adheres to a variety of cells, including erythrocytes. A hemadsorption technique was developed to quantitate adherence by photometric measurement of lysates of erythrocytes that attached to sheets of M. pneumoniae grown in cups of Linbro plates. Attachment of sheep erythrocytes (SE) increased with higher ionic strength, was unaffected by minor pH variations (6 to 9), and was blocked by anti-M. pneumoniae antiserum, but was not inhibited by a variety of sugars, amino acids, and bovine serum albumin. The reaction was time and temperature dependent. The temperature curve showed peaks at 14 and 28 degrees C with untreated SE but only one peak at about 38 degrees C with glutaraldehyde-treated SE. The temperature dependence indicated involvement of either metabolic or membrane activities in the binding process. Trypsin treatment of the M. pneumoniae sheet abolished adherence of SE but was only partially effective with human erythrocytes and noneffective with rabbit erythrocytes. The binding capacity of the mycoplasma cells for SE was restored by incubation in growth medium for 3 to 4 h; this restoration was inhibited by 10 mug of chloramphenicol per ml. Neuraminidase treatment of SE removed their attachment capacity but had no effect on attachment of rabbit erythrocytes and only a slight effect on attachment of human erythrocytes. Pretreatment of M. pneumoniae with neuraminic acid partially blocked the adherence of SE, whereas rabbit erythrocyte attachment was not affected. Attached SE could be detached by trypsin, but not by neuraminidase. For human and rabbit erythrocytes, the results suggest binding mechanisms other than the interaction between neuraminidase-sensitive receptors and protein-containing binding sites shown for SE.

Animals

The protean manifestations of Mycoplasma pneumoniae infection in adults.

Mycoplasma pneumoniae is a well recognized respiratory pathogen in children and young adults. In addition, M. pneumoniae infections may also involve other organ systems. Reviewed here are the various clinical syndromes in adults caused by this infectious agent, with emphasis on those which have recently been seen at The New York Hospital. Two previously unreported manifestations of M. pneumoniae infection, cranial nerve mononeuropathy and hepatitis, are described, and the laboratory methods for diagnosis are discussed.

Adolescent

Interaction of Mycoplasma pneumoniae with alveolar macrophages: viability of adherent and ingested mycoplasmas.

Guinea pig peritoneal or alveolar macrophages were inoculated with Mycoplasma pneumoniae cells. Extracellular mycoplasms were killed by complement treatment, and the effect of macrophage action on the number of the remaining viable mycoplasmas was observed. The complement killing was to some extent inhibited by the presence of the macrophages, but the mechanism of this protection remains unknown. Opsonized mycoplasmas were ingested, and approximately 98% were killed within 4 h. The killing rate was somewhat lower than comparable data for bacteria, but lack of cell wall and high lipid content of the membrane apparently do not cause a significant delay in intracellular destruction.

Animals

Long-term epidemiology of infections with Mycoplasma pneumoniae.

Pneumonia due to Mycoplasma pneumoniae was monitored in a large prepaid medical-care group in Seattle, Washington, between 1963 and 1975. The disease was diagnosed by isolation of M. pneumoniae and/or significant rises in titer of complement-fixing (antilipid) antibody in paired sera. Infection was endemic without significant seasonal fluctuations. Two epidemics occurred: the first peaked in January 1967, the second late in the summer of 1974. Total rates of pneumonia infection in children increased during M. pneumoniae epidemics, but epidemics of infection with respiratory syncytial virus had a greater effect. Age-specific attack rates for M. pneumoniae pneumonia among children aged five to nine years (about six per 1,000) were about twice the rates for younger children and four times those for adults. Serologic study of healthy schoolchildren showed annual rates of infection that paralleled but greatly exceeded rates of recognized M. pneumoniae pneumonia. Infection rates varied from 2% in endemic years to 35% in epidemic periods. A higher proportion of infections among children aged five to nine years than among adolescents aged 15-19 years resulted in pneumonia.

Adolescent

[Detection of Mycoplasma pneumoniae infections in female sex organs].

In the course of isolation experiments on 18 gynaecological patients Mycoplasma hominis was found in the genital organs of five and Mycoplasma pneumoniae in those of three other women. In 2 cases both agents were present. Antibodies against Mycoplasma pneumoniae, Mycoplasma hominis and Mycoplasma orale were in 8,3, respectively 1 serumtests verified. The anamnesis, diagnostics and therapy of the 3 women is reported.

Adult

[Therapeutic effect of midecamycin on Mycoplasma pneumoniae pneumonia in adults (author's transl)].

The clinical efficacy of a macrolide antibiotic, midecamycin, was studied in 12 adult cases with Mycoplasma pneumoniae pneumonia. The therapeutic effects were excellent or good in 9 cases and fair in 2 cases. On defervescence and disappearance of shadows on chest X-ray the therapeutic effect was satisfactory, but on disappearance of cough therapeutic effect was not clear in some cases. Taking into consideration the antimicrobial activity of midecamycin against Mycoplasma pneumoniae, serum concentration and side effects of midecamycin, this antibiotic is expected to be effective in the treatment of Mycoplasma pneumoniae pneumonia.

Adolescent