Nursing Guide to Mycoplasma Pneumonia: Nursing Diagnosis, Interventions, & Care Plans

Etiology and epidemiology 

Mycoplasma pneumoniae is a small, wall-less bacterium that is a frequent cause of community-acquired pneumonia (CAP). It spreads via respiratory droplets, making it highly contagious, particularly in close-contact settings such as schools, military barracks, and households. 

Outbreaks of Mycoplasma pneumoniae are more common in late summer and early fall but can occur year-round. While the disease can affect people of all ages, it’s most commonly seen in individuals age five to 20 years old. 

Key risk factors 

• Close contact in crowded environments (e.g., schools, dormitories)
• Young age (particularly school-age children and young adults)
• Weakened immune systems
• History of smoking or chronic respiratory conditions (e.g., asthma) 

ICD-10 code 

• ICD-10 code for mycoplasma pneumonia: J15.7 (Pneumonia due to Mycoplasma pneumoniae) 

Source: ICD-10 Data 

Diagnosis 

Diagnosing Mycoplasma pneumoniae is based on clinical presentation, exposure history, and laboratory testing. The symptoms develop gradually, often making the infection difficult to distinguish from other respiratory infections. 

Common symptoms of mycoplasma pneumonia 

• Persistent, dry cough (often lasting weeks)
• Low-grade fever
• Sore throat
• Fatigue
• Headache
• Mild chest pain or discomfort
• Wheezing or shortness of breath (in some cases) 

Diagnostic tests 

• Chest X-ray: Though physical examination may show minimal abnormalities, chest X-rays often reveal diffuse, patchy infiltrates, characteristic of atypical pneumonia.
• PCR testing: This is highly sensitive and specific for detecting Mycoplasma pneumoniae DNA in respiratory secretions (include pharyngeal and nasopharyngeal swabs).
• Serologic tests: Antibody testing can confirm the presence of Mycoplasma pneumoniae, though antibodies may take time to appear.
• Cold agglutinin test: This can be positive in some cases of Mycoplasma pneumoniae infections but not highly specific. 

Differential diagnoses include viral pneumonias, bacterial pneumonias (e.g., Streptococcus pneumoniae), bronchitis, and upper respiratory infections. 

Management 

The treatment of Mycoplasma pneumoniae pneumonia focuses on antibiotics and symptom management. Although the disease is often mild, antibiotics shorten the duration of symptoms and reduce the risk of complications. 

Mycoplasma pneumonia treatment options 

Antibiotics 

• Macrolides (e.g., azithromycin, clarithromycin): This is a first-line treatment for Mycoplasma pneumoniae in both children and adults.
• Tetracyclines (e.g., doxycycline): This is effective in older children and adults but contraindicated in children under eight years old due to the risk of tooth discoloration.
• Fluoroquinolones (e.g., levofloxacin): This can be used in adults, especially for patients with macrolide-resistant infections or intolerance. 

Symptomatic treatment 

• Antipyretics/analgesics: Use acetaminophen or ibuprofen to manage fever, headache, and muscle aches.
• Hydration: Encourage increased fluid intake to support hydration.
• Cough management: Cough suppressants may be used to reduce the discomfort of persistent coughing, though it is not typically required. 

Preventive measures 

• Infection control: Patients should practice good hand hygiene and respiratory etiquette (e.g., covering mouth when coughing) to reduce transmission, especially in group settings.
• Isolation: Patients should avoid close contact with others for at least 48 hours after starting antibiotics. 

Mycoplasma Pneumonia nursing care plan 

Nursing considerations 

Nurses help in managing Mycoplasma pneumoniae by focusing on symptom management, promoting airway clearance, and educating patients about their treatment. 

Assessment 

• Respiratory status: Assess for coughing, wheezing, and any difficulty breathing. Monitor lung sounds for crackles or diminished breath sounds.
• Vital signs: Monitor patients’ temperature, respiratory rate, heart rate, and oxygen saturation levels regularly, especially those with comorbidities.
• Hydration status: Evaluate fluid intake and output, especially in patients with fever or those who are not eating or drinking well due to illness.
• General condition: Assess for fatigue, headache, and other systemic symptoms that may affect daily activities. 

Nursing diagnosis/risk for 

• Ineffective airway clearance related to persistent coughing
• Activity intolerance related to fatigue and respiratory symptoms
• Risk for infection transmission related to the contagious nature of Mycoplasma pneumoniae
• Deficient knowledge related to the disease process and antibiotic regimen 

Interventions 

• Administer prescribed antibiotics. Ensure adherence to the prescribed antibiotic regimen and educate patients on the importance of completing the full course.
• Promote airway clearance. Encourage deep breathing exercises, use of a humidifier, and frequent hydration to help loosen mucus and relieve coughing.
• Manage symptoms. Provide antipyretics for fever and ensure the patient is resting adequately to manage fatigue.
• Practice infection control. Educate the patient and family members about preventing the spread of the infection, including hand hygiene and avoiding close contact with others until the contagious period has passed. 

Expected outcomes 

• The patient will demonstrate improved respiratory function with reduced coughing and shortness of breath.
• The patient will complete the full course of antibiotics without complications.
• The patient will report reduced fatigue and an improvement in energy levels, allowing for daily activities.
• The patient will verbalize understanding of infection control measures to prevent the spread of Mycoplasma pneumoniae. 

Individual/caregiver education 

Educating patients and their family members helps ensure effective management and prevent transmission of this condition. Consider the following when providing patient education: 

• Antibiotic adherence: Emphasize the importance of taking the entire prescribed course of antibiotics, even if symptoms improve.
• Infection control: Teach patients to practice good hand hygiene, avoid close contact with others, and cover their mouth when coughing to prevent spreading the infection.
• Symptom monitoring: Educate the patient and caregivers on recognizing worsening symptoms, such as increased shortness of breath, persistent fever, or confusion, which may require medical attention.
• Rest and hydration: Encourage adequate rest and fluid intake to help the body recover more quickly. 

References 

1. Centers for Disease Control and Prevention. (2023). Mycoplasma pneumonia. Retrieved from https://www.cdc.gov/mycoplasma/
2. ICD-10 Data. (2023). J15.7 - Pneumonia due to Mycoplasma pneumoniae. Retrieved from https://www.icd10data.com/ICD10CM/Codes/J00-J99/J10-J18/J15-/J15.7
3. Abdulhadi B, Kiel J. Mycoplasma Pneumonia. (Updated January 2023). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430780/