Acute Pancreatitis Associated with Atypical Bacterial Pneumonia: Systematic Literature Review

Abstract

Background: Extra-pulmonary features sometimes occur in association with atypical bacterial pneumonia and include neurologic manifestations, diarrhea, rashes, altered liver enzymes, or kidney injury, among other conditions. Acute pancreatitis has been associated with atypical pneumonias since 1973. Methods: We performed a systematic review of the literature in the Excerpta Medica, National Library of Medicine, and Web of Science databases. We retained 27 reports published between 1973 and 2022 describing subjects with an otherwise unexplained pancreatitis temporally associated with an atypical pneumonia. Results: The reports included 33 subjects (19 males, and 14 females; 8 children and 25 adults) with acute pancreatitis temporally associated with atypical pneumonia caused by Mycoplasma pneumoniae (n = 18), Legionella species (n = 14), or Coxiella burnetii (n = 1). Approximately 90% of patients (n = 29) concurrently presented with respiratory and pancreatic diseases. No cases associated with Chlamydophila pneumoniae, Chlamydophila psittaci, or Francisella species were found. Conclusions: Acute pancreatitis has been associated with various infectious agents. The present review documents the association with atypical pneumonia induced by Mycoplasma pneumoniae, Legionella species, and Coxiella burnetii.

Pancreatitis associated with Mycoplasma felis infection in a cat

“…In human medicine, several case reports have described patients with acute pancreatitis associated with Mycoplasma pneumoniae infection. 18 –25 The patients typically exhibited respiratory signs as the predominant clinical manifestation, 18,20 which were absent in the cat described here.…”

Acute abdominal pain as the first symptom of Chlamydia psittaci pneumonia complicated by acute pancreatitis: a case report

“…( 11 – 13 ). However, reports of secondary acute pancreatitis in patients with a C. psittaci infection are rare ( 3 ), which may be owing to the low incidence of psittacosis, difficulty of its diagnosis, or lack of clinician awareness. Byrom et al ( 14 ) first reported two cases of C. psittaci pneumonia with concomitant acute pancreatitis in 1979.…”

“…C. psittaci often induces various extrapulmonary complications, such as acute liver injury, acute renal failure, myocarditis, and meningitis ( 2 ). However, the occurrence of secondary acute pancreatitis in patients with C. psittaci pneumonia has rarely been reported ( 3 ). Common symptoms of psittacosis include severe pyrexia, chills, headache, dyspnea, and cough.…”

Valproic Acid-Associated Acute Pancreatitis: Systematic Literature Review

“…Qualified for the study were individuals on long-term (≥4 weeks) therapy with valproic acid presenting with acute-onset abdominal pain, vomiting or distension and at least one of the following [ 1 , 2 , 3 ]: 1. amylase or lipase values three times or more the upper limit of normal (the normal values recommended in the literature were taken into consideration for communications, which did not include any reference); 2. imaging studies, intra-surgical or autoptic findings disclosing features consistent with an acute pancreatitis.…”

“…Chronic alcohol use disorder, gallstone disease, severe hypertriglyceridemia, and hypercalcemia are the most common triggers of acute pancreatitis [ 1 , 2 ]. There is also, but less frequently, an association with genetic factors or with infections of viral (mumps, coxsackievirus, cytomegalovirus, varicella, herpes simplex virus), parasitic (toxoplasma, cryptosporidium, ascaris), fungal (aspergillus), or bacterial (mycoplasma, legionella, leptospira, salmonella) origin [ 1 , 3 ]. Affected patients present with acute-onset severe epigastric and left upper quadrant abdominal pain, usually associated with nausea and vomiting [ 1 ].…”