MYCOPLASMA-PNEUMONIAE - A FREQUENT CAUSE OF PNEUMONIA AMONG US MARINES IN SOUTHERN CALIFORNIA

From August 1993 through April 1994, U.S. Marines (98% male, median ag e 20 years) who were hospitalized with radiographically confirmed pneu monia were prospectively studied for evidence of acute Mycoplasma pneu moniae infection. Overall, 32 (36.4%) of the 88 patients with paired s era had evidence of acute infection by an elevated immunoglobulin M ti ter (22.7%), a 4-fold rise in immunoglobulin G titer (9.1%), a positiv e polymerase chain reaction result (11.1%), and/or a positive culture (5.8%). No specific symptoms or clinical findings were strong predicto rs of M. pneumoniae infection. Among patients with evidence of acute M . pneumoniae infection, admitting clinicians chose other pathogens as more likely etiologic agents 46.4% of the time, and over the course of the hospitalization, 10% of patients failed to receive appropriate an tibiotics. These data indicate that M. pneumoniae may cause a high pro portion of pneumonias among military personnel and should be considere d in empiric treatment and prophylaxis.