Acute respiratory distress syndrome caused by Mycoplasma pneumoniae without elevated pulmonary vascular permeability: a case report

Takahashi, Naoki; Shinohara, Tsutomu; Oi, Rie; Ota, Muneyuki; Toriumi, Shinichi; Ogushi, Fumitaka

doi:10.21037/jtd.2016.03.08

Cited by 13 publications

(3 citation statements)

References 30 publications

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“…Prolonged or inappropriate use of corticosteroids may cause excess downregulation of cell-medicated immunity and result in immunosuppression, making individuals more susceptible to more severe M. pneumoniae infection or opportunistic infections. A recent case report revealed that M. pneumoniae associated ARDS had no elevated pulmonary vascular permeability, and was successfully treated using low-dose short-term hydrocortisone, suggesting that pulmonary infiltration in ARDS caused by M. pneumoniae does not match the criteria of permeability edema observed in typical ARDS [35]. Therefore, careful consideration is required when deciding whether to use high dose corticosteroid in the future cases similar to ours.…”

Section: Discussionmentioning

confidence: 65%

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: Discussionmentioning

confidence: 65%

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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“…Respiratory infections caused by M. pneumoniae are also associated with a wide array of extrapulmonary manifestations such as meningoencephalitis, myocarditis, nephritis, atherosclerosis and mucocutaneous eruptions, etc. [ 13 , 14 , 15 , 16 , 17 ]. More importantly, M. pneumoniae induces mucocutaneous diseases include Stevens-Johnson syndrome and M. pneumoniae -associated mucositis.…”

Section: Introductionmentioning

confidence: 99%

Mycoplasma pneumoniae Infections: Pathogenesis and Vaccine Development

Jiang

Zhu

et al. 2021

Pathogens

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Mycoplasma pneumoniae is a major causative agent of community-acquired pneumonia which can lead to both acute upper and lower respiratory tract inflammation, and extrapulmonary syndromes. Refractory pneumonia caused by M. pneumonia can be life-threatening, especially in infants and the elderly. Here, based on a comprehensive review of the scientific literature related to the respective area, we summarize the virulence factors of M. pneumoniae and the major pathogenic mechanisms mediated by the pathogen: adhesion to host cells, direct cytotoxicity against host cells, inflammatory response-induced immune injury, and immune evasion. The increasing rate of macrolide-resistant strains and the harmful side effects of other sensitive antibiotics (e.g., respiratory quinolones and tetracyclines) in young children make it difficult to treat, and increase the health risk or re-infections. Hence, there is an urgent need for development of an effective vaccine to prevent M. pneumoniae infections in children. Various types of M. pneumoniae vaccines have been reported, including whole-cell vaccines (inactivated and live-attenuated vaccines), subunit vaccines (involving M. pneumoniae protein P1, protein P30, protein P116 and CARDS toxin) and DNA vaccines. This narrative review summarizes the key pathogenic mechanisms underlying M. pneumoniae infection and highlights the relevant vaccines that have been developed and their reported effectiveness.

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“…The airway infections by M. pneumoniae are also connected with several extra-pulmonary complications like nephritis, myocarditis, meningoencephalitis, mucocutaneous disruptions, and atherosclerosis. [11,12] The majority of M. pneumoniae infected pneumonia patients recovered after treatments with tetracycline and macrolides. Although in recent times, the elevating use of antibiotics, the antibiotic-resistant M. pneumoniae strains have emerged and the refractory pneumonia incidences have increased.…”

Section: Introductionmentioning

confidence: 99%

Geraniol relieves mycoplasma pneumonia infection‐induced lung injury in mice through the regulation of ERK/JNK and NF‐κB signaling pathways

Duan

Cheng

et al. 2022

J Biochem & Molecular Tox

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Background: Pneumonia is a serious pediatric lung injury disease caused by Mycoplasma pneumoniae (M. pneumoniae) with increasing global prevalence every year. The WHO has reported that nearly 19% of children die due to pneumonia worldwide.Objective: The present research was conducted to discover the ameliorative properties of geraniol against M. pneumoniae-provoked pneumonia in mice through the modulation of inflammatory responses. Methodology:The pneumonia was provoked in the male Swiss albino mice via infecting animals with 100 µl of M. pneumoniae for 2 days and supplemented concurrently with 20 mg/kg of geraniol for 3 days. 100 mg/kg of azithromycin was used as a standard drug. The nitric oxide (NO) level and MPO activity were measured using kits. The SOD activity, GSH, and MDA levels were studied using standard methods. The polymerase chain reaction (PCR) study was performed to examine the M. pneumoniae DNA load. The inflammatory cytokines status was assessed by assay kits. The ERK1/2, JNK1/2, and NF-κB expressions were studied by reversetranscription (RT-PCR). The lung tissues were analyzed microscopically to investigate the histological alterations.Results: Geraniol treatment effectively reduced lung weight, NO level, and MPO activity in the pneumonia mice. The total cells and M. pneumoniae DNA load were also decreased by the geraniol. The SOD activity and GSH level were improved and MDA was decreased by the geraniol treatment. The IL-1, IL-6, IL-8, TNF-α, and TGF status were appreciably depleted by the geraniol in the pneumonia mice. Geraniol also suppressed the ERK1/2 and NF-κB expressions in the lung tissues. Histological findings also suggest the therapeutic roles of geraniol against pneumonia in mice. Conclusion:In summary, our results proved the beneficial roles of geraniol against the M. pneumoniae-provoked pneumonia. Geraniol could be a hopeful therapeutic agent to treat pneumonia in the future.

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Acute respiratory distress syndrome caused by Mycoplasma pneumoniae without elevated pulmonary vascular permeability: a case report

Cited by 13 publications

References 30 publications

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

Mycoplasma pneumoniae Infections: Pathogenesis and Vaccine Development

Geraniol relieves mycoplasma pneumonia infection‐induced lung injury in mice through the regulation of ERK/JNK and NF‐κB signaling pathways

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