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Kim, Lee, Lee, Jung, Park, Shin, Kim, Lee, Kim, Lee, Shin, and Yong: 2 Cases of Mycoplasma pneumoniae Infection with Severe Pneumonia
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 63(6): 515-520.

Published online: 31 December 2007

DOI: https://doi.org/10.4046/trd.2007.63.6.515

2 Cases of Mycoplasma pneumoniae Infection with Severe Pneumonia

Shin-Tae Kim, M.D., Shun Nyung Lee, M.D., Seok Jeong Lee, M.D., Pil Moon Jung, M.D., Hong Jun Park, M.D., Myung Sang Shin, M.D., Chong Whan Kim, M.D., Bu Ghil Lee, M.D., Sang-Ha Kim, M.D., Won-Yeon Lee, M.D., Kye Chul Shin, M.D., Suk Joong Yong, M.D.

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.

Address for correspondence: Suk Joong Yong, M.D. Department of Internal Medicine, Yonsei University Wonju College of Medicine, 162, Ilsan-dong, Wonju 220-701, Korea. Phone: 82-33-741-1232, Fax: 82-33-746-4667, sjyong@yonsei.ac.kr

Received 12 October 2007       Accepted 6 November 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Mycoplasma pneumoniae (M. pneumoniae) is the leading cause of pneumonia in older children and young adults. Normally, it does not progress to a condition requiring hospitalization but improves spontaneously or has a mild clinical course. We report two cases of M. pneumoniae pneumonia with different clinical manifestations from the normal course. The patients were young healthy individuals. The diagnoses were made by serology. However, it could not be determined beforehand that they had M. pneumoniae pneumonia. Based on the empirical treatment strategy of severe community acquired pneumonia, the patients were treated with broad-spectrum antibiotics including cephalosporin, quinolone and macrolide. After administering the antibiotics, they showed a gradually favorable clinical course and recovered without residual complications. A M. pneumoniae infection should be considered as a cause of severe community acquired pneumonia, and empirical treatment targeting this organism might be helpful in treating patients with the severe manifestation.

Keywords: Mycoplasma pneumoniae, Severe pneumonia, Quinolone, Macrolide

Figures and Tables

Figure 1
A 29-year-old woman with M. pneumoniae pneumonia. Chest radiograph at admission reveals bilateral, patch and lobar consolidation in right upper and left lower lung field (A). Chest CT scan, 2 days later, shows muti-focal consolidation (B). Follow up chest radiograph, 3days later, shows more extensive bilateral consolidation (C). Follow up chest radiograph, 9 days later, shows nearly complete resolution (D).
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Figure 2
A 29-year-old man with M. pneumoniae pneumonia. Chest radiograph at admission reveals bilateral, patch and lobar consolidation in right lower and left upper lung field (A). Chest CT scan shows muti-focal lobar consolidation, mainly in right lower lobe, with pleural effusion (B). Fiberoptic bronchoscopy shows ulcerative lesion covered with necrotic exudation on the posterior wall of trachea (C). Follow up chest radiograph, 3days later, shows more aggravated consolidation (D). Follow up chest radiograph, 13 days later, shows improved state (E).
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Table 1
Cases of M. pneumoniae pneumonia with severe manifestation in Korea
trd-63-515-i001

*titer not described, †negative in initial finding.

ARDS=Acute respiratory distresssyndrome.

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