Thrombosis associated with <i>mycoplasma pneumoniae</i> infection (Review)

Liu, Jingwei; Li, Yumei

doi:10.3892/etm.2021.10399

Cited by 9 publications

(6 citation statements)

References 114 publications

(140 reference statements)

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“…Herein, three patients (12%) had more than one distribution of embolism. One study [ 8 ] reported that the development of the cerebral infarction, abdominal organs and extremities takes 2 days to 3 weeks, 1 week to 1 month and 1–2 weeks respectively. In another study on cardiac embolism among children [ 9 ] caused by Mycoplasma pneumoniae infection, the average diagnostic time of 10 children was 13.3 days which is quite close to what we found in this research.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the risk factors and clinical features of Mycoplasma pneumoniae pneumonia with embolism in children: a retrospective study

et al. 2022

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Background Mycoplasmapneumoniae pneumonia (MPP) is a prevalent disease in community-acquired pneumonia among children. However, in addition to respiratory manifestations, it may also develop extra-pulmonary complications. Embolism is one of the uncommon extra-respiratory manifestations prone to severe sequelae and even death. This study aims to analyze the clinical features of MPP with embolism in children, and explore the associated risk factors of embolism in MPP patients. Methods A retrospective case–control analysis was performed on 48 children with MPP admitted to our hospital wards between January 2010 and December 2021. Embolism group comprised children with embolism by CTA or MRA results, whereas the non-embolism group comprised children with clinical suspicion of embolism but negative diagnostic imaging support. The clinical features, laboratory findings and imaging were analyzed to explore the risk factors for embolism in children with MPP. Results A total of 48 children with MPP were enrolled in the study (16 cases and 32 controls). In the embolism group, 10 patients (62.5%) had pulmonary embolism, 3 patients (18.75%) presented ventricle embolism, 2 patients (12.5%) presented cerebral and carotid artery embolism, one patient (6.25%) had a cerebral embolism, limb, and spleen, respectively. The univariate analysis revealed the maximum body temperature (Tmax), CRP, D-dimer (closest to CTA/MRA), the percentage of neutrophils (N%), pulmonary consolidation (⩾ 2/3 lobe), pleural effusion and atelectasis have significant differences between the embolism group and non-embolism group (P < 0.05). Multivariate logistic regression analysis showed that D-dimer (closest to CTA/MRA) > 3.55 mg/L [OR = 1.255 (95% CI: 1.025—1.537), P < 0.05], pulmonary consolidation (⩾ 2/3 lobe) [OR = 8.050 (95% CI: 1.341—48.327), P < 0.05], and pleural effusion [OR = 25.321 (95% CI: 2.738—234.205), P < 0.01] were independent risk factors for embolism in children with MPP. Conclusion In conclusion, MPP with embolism patients have more D-dimer values and severe radiologic manifestations.

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Section: Discussionmentioning

confidence: 99%

Analysis of the risk factors and clinical features of Mycoplasma pneumoniae pneumonia with embolism in children: a retrospective study

et al. 2022

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“…M. pneumoniae is associated with secondary thrombosis [7]. Previous case reports showed that pulmonary embolism [8] or splenic infarction [9] with M. pneumoniae infection occurred even without pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Challenges in Pulmonary Embolism in Young Adults: Thrombosis Associated With Cytomegalovirus and Mycoplasma pneumoniae

Hikichi¹,

Hasegawa²,

Saga³

et al. 2022

Cureus

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A 23-year-old man presented with a fever, shaking chills, headaches, nausea, and a dry cough. Investigations showed lymphocytic leukocytosis with atypical lymphocytes in a blood smear. Liver function test results, D-dimer concentrations, and fibrin degradation product concentrations were greatly elevated. Computed tomography of the whole body with contrast showed hepatosplenomegaly with splenic infarction and bilateral pulmonary embolism without deep vein thrombosis. Cytomegalovirus (CMV) immunoglobulin M, and serum CMV pp65 antigenemia were positive, and serum Mycoplasma pneumoniae (M. pneumoniae) antibody was also highly positive. These results suggested the diagnosis of co-infection of CMV and M. pneumoniae complicated by systemic arteriovenous thrombosis, which resulted in pulmonary embolism and splenic infarction. After he started edoxaban tosilate hydrate for the thrombosis, his symptoms resolved in a few days. To the best of our knowledge, this is the first case of co-infection of CMV and M. pneumoniae leading to pulmonary embolism and splenic infarction.

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“…According to the study by Liu et al ( 69 ), some factors contributing to thrombosis are transient, while others stem from hereditary thrombophilia in patients experiencing thrombosis due to M. pneumoniae infection. Moreover, specific transient elements, such as cold agglutinin, vascular malformations, sickle cell trait and the presence of positive antibodies such as anticardiolipin, β2-glycoprotein, lupus anticoagulant and anti-prothrombin have been proposed to elevate the risk of thrombosis ( 71 , 72 ). These factors contribute to thrombotic vessel occlusion ( 69 ).…”

Section: Mechanisms Of Extrapulmonary Manifestationsmentioning

confidence: 99%

Exploring the pathogenetic mechanisms of Mycoplasma pneumoniae (Review)

Georgakopoulou,

Lempesis,

Sklapani

et al. 2024

Exp Ther Med

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Mycoplasmas, the smallest self-replicating prokaryotes without a cell wall, are the most prevalent and extensively studied species in humans. They significantly contribute to chronic respiratory tract illnesses and pneumonia, with children and adolescents being particularly vulnerable. Mycoplasma pneumoniae ( M. pneumoniae ) infections typically tend to be self-limiting and mild but can progress to severe or even life-threatening conditions in certain individuals. Extrapulmonary effects often occur without pneumonia, and both intrapulmonary and extrapulmonary complications operate through separate pathological mechanisms. The indirect immune-mediated damage of the immune system, vascular blockages brought on by vasculitis or thrombosis and direct harm from invasion or locally induced inflammatory cytokines are potential causes of extrapulmonary manifestations due to M. pneumoniae . Proteins associated with adhesion serve as the primary factor crucial for the pathogenicity of M. pneumoniae , relying on a specialized polarized terminal attachment organelle. The type and density of these host receptors significantly impact the adhesion and movement of M. pneumoniae , subsequently influencing the pathogenic mechanism and infection outcomes. Adjacent proteins are crucial for the proper assembly of the attachment organelle, with variations in the genetic domains of P1, P40 and P90 surfaces contributing to the variability of clinical symptoms and offering new avenues for developing vaccines against M. pneumoniae infections. M. pneumoniae causes oxidative stress within respiratory tract epithelial cells by adhering to host cells and releasing hydrogen peroxide and superoxide radicals. This oxidative stress enhances the vulnerability of host cells to harm induced by oxygen molecules. The lack of superoxide dismutase and catalase of bacteria allows it to hinder the catalase activity of the host cell, leading to the reduced breakdown of peroxides. Lung macrophages play a significant role in managing M. pneumoniae infection, identifying it via Toll-like receptor 2 and initiating the myeloid differentiation primary response gene 88-nuclear factor κΒ signaling cascade. However, the precise mechanisms enabling M. pneumoniae to evade intracellular host defenses remain unknown, necessitating further exploration of the pathways involved in intracellular survival. The present comprehensive review delves into the pathogenesis of M. pneumoniae infection within the pulmonary system and into extrapulmonary areas, outlining its impact.

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Thrombosis associated with mycoplasma pneumoniae infection (Review)

Cited by 9 publications

References 114 publications

Analysis of the risk factors and clinical features of Mycoplasma pneumoniae pneumonia with embolism in children: a retrospective study

Analysis of the risk factors and clinical features of Mycoplasma pneumoniae pneumonia with embolism in children: a retrospective study

Diagnostic Challenges in Pulmonary Embolism in Young Adults: Thrombosis Associated With Cytomegalovirus and Mycoplasma pneumoniae

Exploring the pathogenetic mechanisms of Mycoplasma pneumoniae (Review)

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