189.4 📌 章末速蚘

  • Mycoplasma: no cell wall → β-lactam useless; smallest free-living
  • M. pneumoniae: walking pneumonia, gradual, dry cough, 圱像 > exam
  • Extrapulmonary: cold agglutinin hemolysis, EM, MIRM, encephalitis/GBS/ADEM, myocarditis, hemolysis/HLH/ITP, arthritis
  • Treatment: azithromycin first (䜆 Asia R 50-90%) or doxycycline or FQ
  • 2023-2024 global outbreak + Asia macrolide R drives doxy preference
  • M. genitalium: STI, NGU/cervicitis/PID; rising azithro R; doxy → azithro sequential or doxy → moxifloxacin; pristinamycin/lefamulin emerging
  • MIRM distinct from SJS/TEN (better prognosis)
  • Cold agglutinin bedside test (RBC clumping on ice)