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[Two cases of Mycoplasma pneumoniae pneumonia with obstructive ventilatory disturbance]
Abstract:
Mycoplasma pneumoniae (M. pneumoniae) pneumonia is usually considered as a benign disease, but in rare cases, the disease is fatal. Fatal cases requiring mechanical ventilation and many extrapulmonary complications have been reported. Cases accompanied with obliterative bronchiolitis also have been reported. Two cases of M. pneumoniae pneumonia with obstructive ventilatory disturbance were reported. In both cases clinical diagnosis of M. pneumoniae pneumonia was confirmed by a rise in the complement fixation antibody titer, a rise of the cold hemagglutinin titer and isolation of M. pneumoniae from sputum and pharynx. In one case we performed transbronchial lung biopsy (TBLB). The lung biopsy specimen showed bronchiolitis, so histological findings were thought to be compatible with ventilatory function. In both cases arterial oxygen pressure (PaO2) was below 60 Torr, by administration of erythromycin (EM) and adrenocorticosteroids, chest X-ray findings, atrial blood gas analysis findings and ventilatory function were improved.
Insights
Mycoplasma pneumoniae pneumonia can cause severe obstructive ventilatory disturbance. Treatment with erythromycin and corticosteroids improved outcomes in two reported cases.
Area of Science:
- Pulmonology
- Infectious Diseases
- Pathology
Background:
- Mycoplasma pneumoniae pneumonia is typically benign but can lead to severe complications.
- Obliterative bronchiolitis and obstructive ventilatory disturbance are rare but serious manifestations.
Observation:
- Two cases of Mycoplasma pneumoniae pneumonia presented with significant obstructive ventilatory disturbance.
- Diagnosis was confirmed by serological tests and pathogen isolation.
- Transbronchial lung biopsy in one case revealed bronchiolitis consistent with ventilatory impairment.
Findings:
- Both patients exhibited severe hypoxemia (PaO2 < 60 Torr).
- Treatment with erythromycin and adrenocorticosteroids led to improvement in chest X-ray, blood gas analysis, and ventilatory function.
Implications:
- This study highlights the potential for Mycoplasma pneumoniae to cause severe obstructive lung disease.
- Early diagnosis and combined therapy with antibiotics and corticosteroids may be crucial for managing these rare, severe cases.