Clinical characteristics of community acquired pneumonia due to Mycoplasma pneumoniae: experience from an outbreak
Abstract
Background: Mycoplasma pneumoniae is a major cause of Community-Acquired Pneumonia (CAP) but often remains underrecognized because it requires molecular or serologic testing for diagnosis. In late 2024, an increase in cases with poor response to macrolides was noted at a tertiary hospital in Thiruvananthapuram, Kerala. This study describes the clinical profile, treatment, and outcomes of patients affected during this outbreak.
Methods: This retrospective study included all patients admitted with M. pneumoniae pneumonia between January 2024 and August 2025. Diagnosis was confirmed by PCR or IgM serology. Clinical features, laboratory parameters, radiologic findings, treatment, and outcomes were collected from records and analyzed using Jamovi (version 2.6.45).
Results: A total of 124 patients were included; 79.8% were <18 years (median age 9 years, IQR 6-14). Diagnosis was PCR-based in 97.6%. Cough (97.6%) and fever (95.2%) were the most common symptoms. Nineteen patients (15.3%) required supplemental oxygen, three (2.4%) non-invasive ventilation, and five (4.0%) invasive mechanical ventilation. Pleural effusion was noted in 24.2%. Extrapulmonary complications were rare, including one case each of encephalitis and pericardial effusion. Definitive therapy included doxycycline in 76.6%, azithromycin in 17.7%, and levofloxacin in 3.2%. One-third of patients initially started on macrolides required a change to alternative agents. Corticosteroids were used in 18.5%, and 33.0%…
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