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Severe hemolytic anemia and excessive leukocytosis masking mycoplasma pneumonia
F Daxböck1, K Zedtwitz-Liebenstein, H Burgmann
1Department for Internal Medicine I, Division of Infectious Diseases and Chemotherapy, University Hospital of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria. florian.daxboeck@klinikum-graz.at
Abstract:
The formation of cold agglutinins is frequently observed during Mycoplasma pneumoniae infections. Nevertheless, severe hemolysis is exceptional. We report a case of life-threatening hemolytic anemia caused by M. pneumoniae. As the leucocyte count was excessively elevated, the differential diagnosis primarily comprised hematological malignancies. The presence of cold agglutinins indicated the correct diagnosis, which was confirmed by highly elevated levels of both IgG and IgM antibodies to M. pneumoniae and a chest X-ray suggestive of atypical pneumonia. The patient was treated with roxithromycin and showed a favorable recovery within ten days after admission. This case demonstrates that, even in patients with clinically mild pneumonia, M. pneumoniae may be the cause of severe anemia.
Insights
Mycoplasma pneumoniae infections can cause cold agglutinins, but severe hemolytic anemia is rare. This case highlights Mycoplasma pneumoniae as a cause of life-threatening anemia, even with mild pneumonia.
Area of Science:
- Infectious Diseases
- Hematology
- Immunology
Background:
- Cold agglutinins are often associated with Mycoplasma pneumoniae infections.
- Severe hemolytic anemia is an uncommon complication of Mycoplasma pneumoniae.
Observation:
- A patient presented with life-threatening hemolytic anemia and elevated white blood cell count, initially suggesting hematological malignancy.
- The presence of cold agglutinins pointed towards Mycoplasma pneumoniae infection.
Findings:
- Diagnosis was confirmed by high IgG and IgM antibody levels to Mycoplasma pneumoniae and chest X-ray findings consistent with atypical pneumonia.
- The patient recovered within ten days after treatment with roxithromycin.
Implications:
- This case underscores that Mycoplasma pneumoniae can cause severe anemia, even in the context of clinically mild pneumonia.
- Highlights the importance of considering Mycoplasma pneumoniae in the differential diagnosis of hemolytic anemia.
- Demonstrates the effectiveness of roxithromycin in treating severe Mycoplasma pneumoniae-induced hemolytic anemia.