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This work was also stimulated by and disseminated through NSF Research Coordination Network Grant, Icotinib in vivo RCN 1051481 and a CSIRO McMaster Fellowship for JT. Authors express their appreciation to Robin Manley, farmer and owner of the property at Avon, for allowing soil sampling. Footnotes 1http://www.biology.duke.edu/fungi/mycolab/primers.htm 2http://icer.msu.edu/hpcc 3http://rdp.cme.msu.edu 4http://www.ebi.ac.uk/ena/ Supplementary Material The Supplementary Material for this article can be found online at: http://journal.frontiersin.org/article/10.3389/fmicb.2016.00824 Click here for additional data file.(1.8M, TIF) Click here for additional data file.(4.4M, TIF) Click here for additional data file.(935K, TIF) Click here for additional data file.(334K, TIF)""Mycoplasma pneumoniae is a common cause of atypical pneumonia often seen in youths and accounts for 10�C15% of cases in Japan (Ishida et al., 2004; Miyashita et al., 2005). M. pneumoniae pneumonia (MPP) is typically mild and characterized by a persistent dry cough, and sometimes self-limiting pneumonia cured with no medication, fulminant cases with severe complications such as respiratory failure, hypoxia, and others have been recognized. Key clinical findings of fulminant MPP involve respiratory failure with diffuse consolidation or an abnormal interstitial pattern on a chest radiograph. Material for this review is based on two review articles by Chan and Welsh (1995) Inulin and Izumikawa et al. (2014), along with one case series study by Miyashita et al. (2007). Table ?Table11 indicates the characters of these three articles. Although the definition of ��fulminant MPP�� has not been established, we defined ��fulminant MPP�� as confirmed MPP cases with respiratory failure or fatal cases without respiratory failure in this review. Table 1 Two review articles and one case series article. Epidemiology Approximately 0.5�C2% of all MPP cases are the fulminant type, but the exact frequency of fulminant MPP is unclear (Chan and Welsh, 1995; Miyashita et al., 2007). Chan and Welsh (1995) reported that fulminant MPP occurs most frequently in adolescent selleck males, especially in those with a history of smoking. Japanese fulminant MPP cases indicated no such trend (Miyashita et al., 2007; Izumikawa et al., 2014). Our data revealed that almost 50% of the 52 fulminant MPP cases occurred in patients aged 20�C49 years, and 13.5% occurred in the elderly (age > 70 years). Only Four cases occurred in younger patients (age