How does a chest X-ray typically look in Mycoplasma pneumoniae compared to typical pneumonia?

• A. Mycoplasma shows patchy, diffuse, or streaky opacities, often bilateral; typical shows dense consolidation
• B. Mycoplasma shows dense lobar consolidation
• C. No radiographic changes
• D. Pleural effusion only

Answer: (A)

The main concept is recognizing the imaging pattern that differentiates atypical pneumonia from typical bacterial pneumonia. Mycoplasma pneumoniae usually produces patchy, diffuse, or streaky opacities on chest X-ray, often seen in both lungs. This reflects an interstitial or bronchopneumonia pattern rather than a single, dense area of consolidation. In contrast, typical pneumonia tends to show dense lobar consolidation in one or more lobes due to alveolar filling with inflammatory exudate. So the described appearance for Mycoplasma—patchy, diffuse or streaky opacities that are often bilateral—is the best fit. While no radiographic changes or a sole pleural effusion can occur in some cases, they are not the characteristic pattern for Mycoplasma pneumoniae.