Lung abscess in a child with Mycoplasma pneumoniae infection

Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in children, while lung abscess is a severe complication of bacterial pneumonias caused mainly by pyogenes. Here we report a previously healthy 10-year-old boy admitted to our unit for a right upper lobe pneumonia, with a 15-day history of fever and cough insensitive to oral amoxicillin and intramuscular ceftriaxone. Chest computed tomography scan revealed that the right upper lobe consolidation was an abscess and that a similar formation was present in the right mid region. Serology allowed the diagnosis of M. pneumoniae infection. The clinical picture rapidly improved after initiation of oral clarithromycin, and radiographic resolution, without sequelae, was observed after 1-month treatment. Lung abscess in children is a rare complication of M. pneumoniae infection and only three previous cases have been described in the literature, all associated with a delayed diagnosis and late initiation of macrolide therapy. A long-term treatment with oral macrolide allows a prompt recovery and restitution ad integrum of the lung.     

Mycoplasma pneumoniae infection in a child after renal transplantation

Although Mycoplasma pneumoniae infections are common among school children and young adults, they have been rarely reported in renal transplant recipients. Herein, we report an 8-yr-old boy who had M. pneumoniae infection 1 yr after transplantation and showed liver dysfunction during the course of the disease. In children who underwent renal transplantation and receive immunosuppressive treatment, we suggest that symptoms of a simple upper respiratory tract infection may precede M. pneumoniae disease with potentially serious extrapulmonary complications.     

Recurrent Mycoplasma pneumoniae infection in a human immunodeficiency virus-positive child

Mycoplasma pneumoniae is a frequent cause of community-acquired respiratory infections, especially in young children and adolescents. The significance of M. pneumoniae infection in HIV-positive patients, particularly children, is not well described. This report describes an HIV-positive female child with recurrent B-cell lymphoma and recurrent or relapsing pulmonary infections with M. Pneumoniae.     

Chronic Mycoplasma pneumoniae infection in a child after renal transplantation

Schwerk N, Hartmann C, Baumann U, Pape L, Ehrich JHH, Hansen G. Chronic Mycoplasma pneumoniae infection in a child after renal transplantation.
Pediatr Transplantation 2010: 14: E26–E29. © 2009 John Wiley & Sons A/S. Abstract: Mycoplasma pneumoniae has rarely been reported in renal transplant recipients. We present the case of a 10‐yr‐old boy with a six‐month history of chronic cough, recurrent pyrexia, and weight loss three yr after RTx. The patient's post‐transplant course was complicated by recurrence of NS that resolved with plasmapheresis and PTLD, which was successfully treated with an anti‐CD20 monoclonal antibody. Chest X‐ray showed a round mass‐like lesion in the left upper lobe; MRT, PET, and bronchoscopy ruled out a PTLD. BAL fluid revealed M. pneumoniae‐DNA. A three‐wk course of macrolide therapy induced rapid recovery. We conclude that M. pneumoniae infection should be considered in immunosuppressed patients with long‐lasting respiratory complaints and fever of unknown origin. Antibiotic treatment should be given for a minimum of three wk.     

Internal carotid artery occlusion associated with Mycoplasma pneumoniae infection in a child

We describe a seven-year-old girl with severe pneumonia probably associated with Mycoplasma pneumoniae who developed right-sided hemiparalysis and right central facial paralysis soon after the onset of the disease. Cerebral magnetic resonance imaging revealed left corpus striatum acute infarction and magnetic resonance angiography demonstrated left internal carotid artery occlusion. She also had positive antiphospholipid and anticardiolipin antibodies and increased fibrinogen and D-dimer levels.     

Mycoplasma pneumoniae infection and neurological disease

The cases are reported of 13 children seen over a 22 month period who presented with a variety of acute neurological illnesses associated with Mycoplasma pneumoniae infection. Although presentation with a decreased level of consciousness or seizures was common, psychosis, hemiparesis, cranial nerve palsies, and Guillain-Barré syndrome were also seen. In contrast with published reports, only one child had an associated chest infection. Although some children have been left with residual disability, most have made a complete recovery. In this recent experience, M pneumoniae is a not rare cause of neurological illness in childhood and may present in unusual ways.     

Multiple hypoechoic lesions in spleen and Mycoplasma pneumoniae infection

An 8-year-old boy was admitted because of recurrent fever for 1 month with increased CRP and ESR. Ultrasound reviewed multiple, small, hypo-echoic, rounded and wedge-shaped nodules with diffuse blood flow in spleen and enlarged abdominal lymph nodes. The spleen was enlarged and no echoic space was found in the largest lesion on 5th day. After a positive mycoplasma pneumoniae (MP) IgM was reported on 6th day, azithromycin was used intravenously. The temperature returned to normal and CRP and ESR improved in a short period. The lesions and lymphadenopathy disappeared and MP IgM antibody became negative 6 months later.     

Mycoplasma pneumoniae infection and neurological disease.

The cases are reported of 13 children seen over a 22 month period who presented with a variety of acute neurological illnesses associated with Mycoplasma pneumoniae infection. Although presentation with a decreased level of consciousness or seizures was common, psychosis, hemiparesis, cranial nerve palsies, and Guillain-Barré syndrome were also seen. In contrast with published reports, only one child had an associated chest infection. Although some children have been left with residual disability, most have made a complete recovery. In this recent experience, M pneumoniae is a not rare cause of neurological illness in childhood and may present in unusual ways.     

Mycoplasma pneumoniae infection. Manifestation in a 3-year-old child by Raynaud's phenomenon

The authors report the case of a 3 year-old boy with mycoplasma pneumoniae infection. The presenting sign was Raynaud's phenomenon with cryoglobulinemia and cryofibrinogenemia. To their knowledge this is the first reported case presenting with such an association.     

Mycoplasma pneumoniae infection in a clinical setting

Background: Mycoplasma pneumoniae infection predominantly affects the respiratory tract, although the other organs may also be involved. Previous studies compared the clinical features of patients with M. pneumonia pneumonia to other pathogens and these studies were predominantly adult case series rather than involving children. The objectives of the present study were to compare the clinical features, laboratory, and radiographic findings in children seropositive for M. pneumoniae infection with children tested for suspected M. pneumoniae infection who were seronegative. Methods: Using a retrospective review of children who had complement fixation test (CFT) performed for suspected M. pneumoniae infection, children were classified as seropositive if the acute phase serum titer was ≥64, or paired samples taken 2–4 weeks apart showed a fourfold or greater rise in serum titer. In contrast, a patient with an antibody titer <64 or with paired sera showing less than a fourfold rise in titer was considered seronegative. Results: One hundred and fifty‐one children were included. Seventy‐six children had serological evidence of M. pneumoniae infection and the remaining 75 were seronegative. Children with M. pneumoniae infection were more likely to have fever >6 days duration prior to admission, crackles on auscultation, radiographic consolidation and thrombocytosis at presentation. In addition, M. pneumoniae infection was associated with pneumonia whereas seronegative children were more likely to have upper respiratory tract infection or asthma. Conclusions: Certain clinical parameters could assist in gauging the likelihood of M. pneumoniae infection in children, and thus direct whether antibiotic treatment is needed.     

Carditis associated with Mycoplasma pneumoniae infection

A 16-year-old boy with acute perimyocarditis had serological evidence of Mycoplasma pneumoniae infection. The endomyocardial biopsy specimen showed grade 2 active lymphocytic myocarditis. A T-cell study suggested a cell-mediated immune process in the pathogenesis of carditis. Mycoplasma pneumoniae needs to be considered as a possible cause of acute carditis, and histological findings may influence management.     

Mycoplasma pneumoniae infection in children with acute respiratory infection

A prospective study was performed on 93 children admitted to Kasturba Medical College Hospital, Manipal and TMA Pai Rotary Hospital of Udupi and Karkala. Blood samples from 93 children admitted to the ward with no respiratory illness were taken as age-matched controls for the inpatients, IgM antibody against Mycoplasma pneumoniae was detected using a commercial kit (Virion-Serion ELISA, Germany) following the manufacturer's instructions. 23.96% of the inpatients with respiratory tract symptoms had IgM antibodies against Mycoplasma pneumoniae. The highest infection rate was found to be in the 2-5 and 5-10 year age group. The most common mode of presentation was an upper respiratory focus of infection with cervical lymphadenopathy. Bronchial breathing signifying pneumonic consolidation was significantly less in the Mycoplasma positive group (p = 0.006). There was no statistically significant difference in the radiological findings in the Mycoplasma positive and Mycoplasma negative groups.     

肺炎支原体感染与喘息的关系探讨

<正> 喘息症状在小儿呼吸道疾患中较为常见。为了探讨肺炎支原体感染与喘息的关系,对我院2000年12月至2001年9月收治的小儿肺炎进行了初步研究。     

支原体肺炎合并肺栓塞一例临床分析

目的 探讨儿童支原体肺炎合并肺栓塞的诊断要点.方法 回顾性分析1例支原体肺炎合并肺栓塞的临床、辅助检查特点和随访情况,并复习文献,探讨支原体肺炎合并肺栓塞的诊断要点.结果 患儿男,6岁,以发热、咳嗽半月为主要表现.呼吸稍费力,胸痛.左侧胸部呼吸动度减弱,左下肺叩诊浊音,左侧呼吸音稍低,闻及少许细湿哕音.辅助检查:胸腔积液常规检查示混浊血性液,WBC 368×106/L,RBC 7140×106/L,N0.61,L0.12.酶联免疫法查支原体抗体IgM 1:128阳性,冷凝集素试验示1:1024阳性.血D-D二聚体14.81 mg/L.血抗心磷脂抗体阳性.血浆蛋白C活性60％(正常70％～ 130％).肺动脉血管造影示左肺下叶呈大片状密度增高影,左侧支气管动脉下支分支血管部分截断.心脏B超提示三尖瓣瓣口轻度反流,肺动脉收缩压约38 mm Hg(1 mm Hg=0.133 kPa).单光子发射计算机断层显像术示左肺背段、前基段、外基段、下舌段明显放射性分布稀疏.入院后考虑支原体肺炎伴胸腔积液、肺栓塞,予美洛培南针联合红霉素针抗感染,低分子肝素针和华法林片抗凝后胸腔积液消失,血D-D二聚体0.38 mg/L,肺动脉压力降低.随访显示抗心磷脂抗体转阴,血浆蛋白C活性恢复,肺部病变吸收.结论 支原体肺炎患儿有胸痛、呼吸困难、血性胸腔积液、肺动脉高压、抗磷脂抗体阳性、D-D二聚体增高时要考虑肺栓塞的可能,肺动脉血管造影可明确诊断.