Kosin Med J.  2019 Jun;34(1):57-64. 10.7180/kmj.2019.34.1.57.

Mycoplasma Pneumoniae-Associated Necrotizing Pneumonia in Children: a case-report

• Lee CH
• Jo SY
• Na KW
• Kim SW
• Hwang YH

• KMID: 2451777
• DOI: http://doi.org/10.7180/kmj.2019.34.1.57

Abstract

Mycoplasma pneumoniae is the most common bacterial strain causing atypical pneumonia in children and adolencents. Although it is known to cause mild symptoms, it can also cause severe pulmonary or extrapulmonary complications in rare cases. Necrotizing pneumonia (NP) is often reported as a complication of Streptococcus pneumoniae and is very rarely caused by M. pneumoniae. We report a case in which a 5-year-old boy was diagnosed with lobar pneumonia with symptoms that aggravated even with macrolide antibiotic treatment. Anti-mycoplasma pneumoniae Ig-M test yielded high values, and direct polymerase chain reaction results were also positive. NP caused by M. pneumoniae was confirmed on computed tomography. After treatment involving tosufloxacin and systemic steroid, the lesion decreased in size and improved gradually when followed-up for more than 1 year. The patient did not have any predisposing or risk factors for NP.

Keyword

Mycoplasma pneumoniae; Necrotizing pneumonia; Pneumonia

MeSH Terms

Child*
Child, Preschool
Humans
Male
Mycoplasma pneumoniae
Mycoplasma*
Pneumonia*
Pneumonia, Mycoplasma
Polymerase Chain Reaction
Risk Factors
Streptococcus pneumoniae

Figure

• 

  Fig. 1 Chest x-ray findings of case (A) Performed on the day of admission, showing pneumonic infiltration of both lung fields as well as pleural effusion of the left lung field (white arrow). (B) Performed on Day 10 of admission, showing slight improvement in pneumonic consolidation in both lung fields, and cavity formation (white arrow) in both the left lower lung and retrocardiac space.

• 

  Fig. 2 Contrast-enhanced chest computed tomography findings of case (A, B) Computed tomography of the chest performed on Day 10 of admission, showing consolidation in the left lower lobe and multiple air-filled cavities (white arrow), and indicating necrosis of the pneumonia.

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