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Head lice (pediculosis) 

Head lice (pediculosis)
Chapter:
Head lice (pediculosis)
DOI:
10.1093/med/9780198729228.003.0093
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date: 26 June 2019

Mycoplasmas are the smallest free-living forms and ubiquitous pathogens. The family Mycoplasmataceae is composed of two genera responsible for human infection Mycoplasma and Ureaplasma. Mycoplasma pneumoniae is endemic worldwide, and manifest infections occur in all ages but are usually predominant in school-aged children and young adults. M. pneumoniae infections are generally mild and self-limiting, and the commonest clinical syndromes are respiratory tract infections. M. pneumoniae is also often associated with extrapulmonary diseases involving almost any organ system, with encephalitis and Guillain–Barré syndrome constituting the most severe manifestations. Recent studies have indicated that carriage of M. pneumoniae in the upper respiratory tract is relatively high and current diagnostic procedures are unable to differentiate between bacterial carriage and infection. It is therefore possible that the burden of M. pneumoniae-associated disease is overestimated. A more reliable diagnosis of M. pneumoniae infection may be achieved by using paired sera in order to detect seroconversion and/or a fourfold increase in antibody titres, in addition to polymerase chain reaction. Furthermore, there is no clear evidence that antibiotic treatment of M. pneumoniae respiratory tract infections is effective. The first-line antibiotics for M. pneumoniae infections in children are macrolides. Rapid worldwide emergence of macrolide-resistant M. pneumoniae necessitates the implementation of restrictive policies regarding the use of macrolides. Current guidelines for the management of community-acquired pneumonia in children recommend empiric macrolides against M. pneumoniae at any age if there is no response to first-line β‎-lactams or in the case of very severe disease.

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