Pediatr Gastroenterol Hepatol Nutr.  2017 Jun;20(2):124-129. 10.5223/pghn.2017.20.2.124.

Pediatric Mycoplasma pneumoniae Infection Presenting with Acute Cholestatic Hepatitis and Other Extrapulmonary Manifestations in the Absence of Pneumonia

• Song WJ
• Kang B
• Lee HP
• Cho J
• Lee HJ
• Choe YH

• KMID: 2384826
• DOI: http://doi.org/10.5223/pghn.2017.20.2.124

Abstract

Mycoplasma pneumoniae infections mainly involve respiratory tract; however, also can manifestate other symptoms by site involved. Extrapulmonary manifestations of M. pneumoniae infection are rarely known to occur without pneumonia. Herein we report a case of a 9-year-old boy who presented with acute cholestatic hepatitis in the absence of pneumonia. Rhabdomyolysis, skin rash, and initial laboratory results suspicious of disseminated intravascular coagulopathy were also observed in this patient. M. pneumoniae infection was identified by a 4-fold increase in immunoglobulin G antibodies to M. pneumoniae between acute and convalescent sera by enzyme-linked immunosorbent assay. This is the first pediatric case in Korea of M. pneumoniae infection presenting with acute cholestatic hepatitis in the absence of pneumonia.

Keyword

Hepatitis; Mycoplasma pneumoniae; Extrapulmonary manifestation

MeSH Terms

Antibodies
Child
Enzyme-Linked Immunosorbent Assay
Exanthema
Hepatitis*
Humans
Immunoglobulin G
Korea
Male
Mycoplasma pneumoniae*
Mycoplasma*
Pneumonia*
Pneumonia, Mycoplasma*
Respiratory System
Rhabdomyolysis
Antibodies
Immunoglobulin G

Figure

• 

  Fig. 1 Chest radiography at admission shows no abnormal lesions in the lung.

• 

  Fig. 2 Computed tomography of the abdomen at admission reveals (A) mild hepatomegaly with periportal edema, and (B) diffuse edematous change of the gallbladder.

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