Adult respiratory distress syndrome due to mycoplasma pneumonia

Shah, D. C.; Muthiah, Muthu

doi:10.1136/pgmj.72.846.241

Cited by 6 publications

(3 citation statements)

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“…M. pneumoniae pneumonia is typically mild and characterized by a persistent dry cough or self-limiting pneumonia that resolves with no medication [3]. However, respiratory failure and severe acute respiratory distress syndrome (ARDS) occur in 0.5-2% of all M. pneumoniae pneumonia cases and primarily affect young adults [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. The rates of intensive care unit (ICU) admission of hospitalized M. pneumoniae pneumonia patients are reported as 10% in the US and 16.3% in Europe [19,20].…”

Section: Introductionmentioning

confidence: 99%

Early diagnosis and appropriate respiratory support for Mycoplasma pneumoniae pneumonia associated acute respiratory distress syndrome in young and adult patients: a case series from two centers

Ding

Zhao

et al. 2020

BMC Infect Dis

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Background: Mycoplasma pneumoniae (M. pneumoniae) is one of the most common causes of community acquired pneumonia (CAP). Establishing an early diagnosis of M. pneumoniae pneumonia in patients with acute respiratory distress syndrome (ARDS) may have important therapeutic implications. Methods: We describe diagnosis and management of M. pneumoniae pneumonia induced ARDS in a case series of adults and youth hospitalized with radiographically confirmed CAP prospectively enrolled in an observational cohort study in two university teaching hospitals, from November 2017 to October 2019. Results: In all 10 patients, early and rapid diagnosis for severe M. pneumoniae pneumonia with ARDS was achieved with polymerase chain reaction (PCR) or metagenomic next-generation sequencing (mNGS) testing of samples from the lower respiratory tract or pleural effusion. The average PaO 2 /FiO 2 of all patients was 180 mmHg. Of the 10 cases, 4 cases had moderate ARDS (100 mmHg ≤ PaO 2 /FiO 2 < 200 mmHg) and 3 cases had severe ARDS (PaO 2 /FiO 2 < 100 mmHg). High flow nasal cannula (HFNC) was applied in all patients, though only two patients were sufficiently supported with HFNC. Invasive mechanical ventilation (IMV) was required in 5 patients. High resistance (median 15 L/cmH 2 O/s) and low compliance (median 38 ml/cmH 2 O) was observed in 4 cases. In these 4 cases, recruitment maneuvers (RM) were applied, with 1 patient demonstrating no response to RM. Prone positioning were applied in 4 cases. Two cases needed ECMO support with median support duration of 5.5 days. No patient in our case series received corticosteroid therapy. All patients were survived and were discharged from hospital.

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Section: Introductionmentioning

confidence: 99%

Early diagnosis and appropriate respiratory support for Mycoplasma pneumoniae pneumonia associated acute respiratory distress syndrome in young and adult patients: a case series from two centers

Ding

Zhao

et al. 2020

BMC Infect Dis

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“…Mycoplasmal pneumonia is considered to be a relatively benign disease that is improved by appropriate treatment with antimicrobial agents in many cases, even though it presents symptoms such as high fever, persistent cough and dyspnoea. However, in some cases it becomes severe by presenting multivarious clinical features (Shah & Muthiah, 1996), such as the development of bronchial asthma (Yano et al, 1994) and complication by extraplumonary lesions (Fernald et al, 1975).…”

Section: Introductionmentioning

confidence: 99%

Immunological analysis and pathological examination of gnotobiotic mice monoassociated with Mycoplasma pneumoniae

Sekine

Taguchi

Watanabe

et al. 2009

Journal of Medical Microbiology

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Although mycoplasmal pneumonia has been generally considered to be a disease with good prognosis, a pathogenic host immune response has been associated with its occurrence. In the present study, the pathogenic significance of the immune response was examined using germfree mice either infected intranasally with Mycoplasma pneumoniae or inoculated with M. pneumoniae antigens (soluble antigen and partially purified antigen). In gnotobiotic mice monoassociated with M. pneumoniae, 10 4 c.f.u. M. pneumoniae per lung were isolated 2-28 days after infection. Inflammatory changes with infiltration of lymphocytes were histopathologically detected in the perivascular area at 2 and 7 days after infection. In the mice intranasally inoculated with soluble antigen or partially purified antigens (F6 and F10 antigens), infiltration of neutrophils and lymphocytes was histopathologically detected at 2 days after inoculation. Severe pneumonia with tissue destruction was observed in the mice inoculated with F6 antigen. A gamma interferon (IFN-c) dominant response in endogenous cytokine expression was observed in all the treated mice. These results indicate that inflammatory changes in the lung tissue were prolonged in gnotobiotic mice monoassociated with M. pneumoniae compared with mice inoculated with M. pneumoniae antigen. In addition, it was shown that IFN-c plays an important role in the pathogenesis of pneumonia in mice either infected with M. pneumoniae or inoculated with its antigen. In particular, the F6 antigen has been considered to be an important virulence factor in terms of induction of tissue injury causing infiltration of lymphocytes and neutrophils in the lung, suggesting a close interaction between the immune response and the occurrence of M. pneumoniae pneumonia.

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“…Although not common, respiratory failure has been documented even in previously healthy patients. [23][24][25] In addition to pneumonia, M pneumoniae has also been associated with pharyngitis, bronchitis, 26 asthma, 27,28 bronchiolitis obliterans, 29,30 acute respiratory distress syndrome, 24,31,32 pericardi-tis, [33][34][35] mediastinitis, 36 arthritis, 37,38 Stevens-Johnson syndrome and erythema multiforme, 39,40 erythema nodosum, 41 meningoencephalitis, [42][43][44][45] and stroke. 46 Rarely, deaths have been attributed to Mycoplasma infections.…”

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confidence: 99%

Mycoplasma Disease and Acute Chest Syndrome in Sickle Cell Disease

Neumayr¹,

Lennette

Kelly³

et al. 2003

Pediatrics

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M pneumoniae is commonly associated with the ACS in patients with sickle cell anemia and occurs in very young children. M hominis should be considered in the differential diagnosis of ACS. Aggressive treatment with broad-spectrum antibiotics, including 1 from the macrolide class, is recommended for all patients as well as bronchodilator therapy, early transfusion, and respiratory support when clinically indicated.

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Adult respiratory distress syndrome due to mycoplasma pneumonia

Cited by 6 publications

References 1 publication

Early diagnosis and appropriate respiratory support for Mycoplasma pneumoniae pneumonia associated acute respiratory distress syndrome in young and adult patients: a case series from two centers

Early diagnosis and appropriate respiratory support for Mycoplasma pneumoniae pneumonia associated acute respiratory distress syndrome in young and adult patients: a case series from two centers

Immunological analysis and pathological examination of gnotobiotic mice monoassociated with Mycoplasma pneumoniae

Mycoplasma Disease and Acute Chest Syndrome in Sickle Cell Disease

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