A case of lung transplantation following Mycoplasma pneumoniae infection

• Published in: European journal of clinical microbiology & infectious diseases 2002-04, Vol.21 (4), p.318-322
• Main Authors: DAXBÖCK, F, BRUNNER, G, POPPER, H, KRAUSE, R, SCHMID, K, KREJS, G. J, WENISCH, C
• Format: Article
• Language: English
• Subjects: Anemia; Anti-Bacterial Agents - therapeutic use; Antibodies; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Bronchiolitis obliterans; Bronchopneumonia; Clarithromycin - therapeutic use; Complement fixation; Doxycycline - therapeutic use; Effusion; Fluoroquinolones; Hemorrhage; Human bacterial diseases; Humans; Infections; Infectious diseases; Lactams; Lung diseases; Lung Transplantation; Lung transplants; Lungs; Male; Medical sciences; Middle Aged; Mycoplasma pneumoniae; Mycoplasma pneumoniae - isolation & purification; Pancreatitis; Parenchyma; Pneumonia; Pneumonia, Mycoplasma - microbiology; Pneumonia, Mycoplasma - therapy; Polymerase chain reaction; Reiter's disease; Renal failure; Rhabdomyolysis; Signs and symptoms; Stevens-Johnson syndrome; Transplantation; Treatment Failure; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-002-0698-0

Reported here is a case of severe necrotizing pneumonia following Mycoplasma pneumoniae infection that occurred in a 55-year-old man. The histological changes of lung parenchyma included granulomas and bronchiolitis obliterans. Mycoplasma infection was diagnosed by repeated antibody determination (complement fixation test) and confirmed using the polymerase chain reaction to detect the pathogen from a tracheal aspirate. Prior to this episode of pneumonia, the patient had been healthy, except for Reiter's disease that had been diagnosed 18 years previously. In addition to severe pulmonary involvement, the patient developed rhabdomyolysis with subsequent acute renal failure, Stevens-Johnson syndrome, biochemical pancreatitis, severe anemia, and an effusion of the right knee. Contrary to the symptoms of pulmonary disease, all of the extrapulmonary manifestations except anemia were transient. Due to persistent respiratory insufficiency and long-term failure to wean the patient from a respirator, a lung transplantation was performed. Five weeks after transplantation the patient died as a result of intrapulmonary hemorrhage. To the best of our knowledge, this is the first report of pneumonia due to Mycoplasma pneumoniae leading to lung transplantation. Furthermore, the multiple extrapulmonary manifestations in this case make it exceptional.