Fatal hyperammonaemia caused by Mycoplasma hominis

Acute idiopathic hyperammonaemia has been noted during treatment for acute leukaemia,1 stem cell transplantation, and organ transplantation, including lung.2 The cause of the disorder in each case remained undetermined, but pre-mortem blood cultures grew M hominis in one reported patient.1 An acquir...

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Bibliographic Details
Published in:The Lancet (British edition) 2013-12, Vol.382 (9908), p.1956-1956
Main Authors: Wylam, Mark E, Dr, Kennedy, Cassie C, MD, Hernandez, Nina M, BS, Peters, Steve G, Prof, Maleszewski, Joseph J, MD, Cassivi, Stephen D, Prof, Scott, John P, Prof
Format: Article
Language:English
Subjects:
Aminoacid disorders
Ammonia
Biological and medical sciences
Blood
Cell culture
Culture media
Errors of metabolism
Fatal Outcome
Female
General aspects
Humans
Hyperammonemia - immunology
Hyperammonemia - microbiology
Hyperglycemia
Immunocompromised Host
Internal Medicine
Leukemia
Lung Transplantation
Medical research
Medical sciences
Metabolic diseases
Middle Aged
Mycoplasma hominis - isolation & purification
Mycoplasma Infections - complications
Mycoplasma Infections - immunology
Postoperative Complications - immunology
Stem cells
Transplants & implants
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Summary:Acute idiopathic hyperammonaemia has been noted during treatment for acute leukaemia,1 stem cell transplantation, and organ transplantation, including lung.2 The cause of the disorder in each case remained undetermined, but pre-mortem blood cultures grew M hominis in one reported patient.1 An acquired reduction in hepatic glutamine synthetase activity has been suggested. Schimke and Barile4 showed that the breakdown of arginine to ornithine occurs by arginine deiminase, an enzyme which is 10% of the mass volume of the bacterium. [...]the recent use of PCR for M hominis, the static effects of sodium polyanethol sulphonate, the anticoagulant in automated liquid blood culture media systems has greatly reduced the sensitivity of detection of mycoplasma.5 We can reasonably conclude that acute hyperammonaemia in this lung transplant recipient was due to occult M hominis infection.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(13)62115-7