Severe Mycoplasma pneumoniae infection requiring extracorporeal membrane oxygenation with concomitant ischemic stroke in a child

Abstract

Mycoplasma pneumoniae is one of the most common agents causing respiratory disease in children. The most common extra-pulmonary manifestations of M. pneumoniae include central nervous system involvement, with stroke being an uncommon but devastating consequence. We present a 13-year-old girl with severe respiratory disease requiring extracorporeal membrane oxygenation, who developed ischemic stroke associated with clinical and serologic evidence of M. pneumoniae. A case of M. pneumoniae causing this degree of respiratory failure associated with stroke has not been previously reported. Prompt recognition of severe mycoplasmal infection may allow for earlier treatment and concomitant evaluation of neurologic injury.

Low Bacterial Co-infection Invalidates the Early Use of Non-anti-Mycoplasma pneumoniae Antibiotics in Pediatric Refractory Mycoplasma pneumoniae Pneumonia Patients

“…Most RMPP cases were reported in East Asia and we found although there was no evidence of bacterial co-infection in previous studies, surprisingly, non-anti-MP antibiotics were commonly administrated to pediatric RMPP patients not only in East Asia ( 1 , 2 , 31 , 38 – 41 ), but also in Australia ( 42 ) and USA ( 43 – 45 ). In the present study, up to 93.33% of total patients were treated with non-anti-MP antibiotics, even last-line antibiotics, such as glycopeptides or carbapenems (Table 2 ).…”

Atypical Pneumonia

“…92 In patients with central nervous system syndromes from M pneumoniae , such as encephalitis and stroke, case reports have suggested the use of steroids and immunoglobulin therapy may be of benefit, although this has not been validated in clinical trials. 5,93 Similar reports have been made for patients with severe M pneumoniae pneumonia resulting in acute respiratory distress syndrome, suggesting possible benefit from extracorporeal membrane oxygenation and steroids. 5,84,88 Antimicrobial options are summarized in Table 2.…”

“…5,93 Similar reports have been made for patients with severe M pneumoniae pneumonia resulting in acute respiratory distress syndrome, suggesting possible benefit from extracorporeal membrane oxygenation and steroids. 5,84,88 Antimicrobial options are summarized in Table 2.…”

“…Rainfall, high humidity, and work in gardens with compost are risk factors for acquiring Legionella disease. 5–7 Most of the cases of legionnaires’ disease are associated with Legionella pneumophila , but many other bacterial species have been found to cause Legionella lung infections. 7,8 …”

Insights into the Therapeutic of Glucocorticoid for Refractory Mycoplasma Pneumoniae Pneumonia in Children

“…Mycoplasma Pneumoniae Pneumonia (MPP) is usually considered as a benign and self-limiting disease. However, it has been found in clinical practice that some children still progress to refractory mycoplasma pneumoniae pneumonia(RMPP) after being treated with su cient and long-term macrolide antibiotics in timely [2][3][4][5][6][7] , it often leads to serious internal and external pulmonary complications, such as pulmonary necrosis and pleural effusion, which may not only di cult to treat and increase medical expenses, but also leave sequelae such as bronchiectasis, atelectasis, necrotizing pneumonia and bronchiolitis obliterans [8][9][10][11][12] , affecting the quality of life. More worryingly, the prevalence of RMPP is increasing due to the abuse of macrolides and the emergence of drug-resistant strains [13,14] .…”