[Macrolide resistance in Mycoplasma pneumoniae by recurrence and extended illness]

A 36 year-old female with a Mycoplasma pneumoniae (MP) infection was treated with azithromycin. She recovered transitory, but experienced a relapse a few days later. After ten days she visited her general practitioner again; she was tired and weakened, had a debilitating dry cough and a weight loss of 6 kg. A throat swab was positive for MP by a polymerase chain reaction (PCR). It was investigated by sequencing and a mutation corresponding to a A2063G transition in domain V of the 23S rRNA known to be associated with macrolide resistance was detected. Twenty-two days later, MP could still be detected by PCR on a nasopharyngeal secretion.