[A case of fulminant Mycoplasma pneumoniae pneumonia despite adequate antibiotic treatment]

A 35-year-old woman complaining of fever and cough consulted a local clinic. She did not recover despite treatment with oral azithromycin, and a chest X-ray demonstrated infiltrates in both lungs. She was then admitted to our hospital and treated with intravenous pazufloxacin and oral clarithromycin. However, she did not respond to the treatment and her respiratory condition deteriorated. Thereafter, she was treated with high doses of corticosteroids, and her condition rapidly improved radiologically and clinically. The diagnosis was confirmed to be Mycoplasma pneumoniae pneumonia by the increased antibody-titer and positive M. pneumoniae PCR of bronchoalveolar lavage. In summary, we encountered a case of severe M. pneumoniae pneumonia, which induced acute respiratory failure even though the patient was receiving appropriate antibiotic treatment. The patient was recovered with steroid pulse therapy.