When to suspect a pulmonary infection due to Mycoplasma pneumoniae or Chlamydia pneumoniae in a patient with asthma:
(1) unexplained acute exacerbation or chronic worsening of the asthma
(2) chronic cough or wheezing
(3) recent history of atypical pneumonia
(4) an occupation with exposure to the organisms, such as health care
(5) exposure to someone with Mycoplasma pneumoniae or Chlamydia pneumoniae or the occurrence of an epidemic in the community
(6) school-aged child >= 5 years of age (Mycoplasma)
While culture can be used to isolate the organisms, PCR is more sensitive.
Other ways of making the diagnosis:
(1) seroconversion or rise in titer in serum antibodies
(2) clinical improvement following therapy with clarithromycin
