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Published on: February 24, 2023
Mycoplasma pneumoniae-associated Hepatitis without Lung Involvement
Han Taek Jeong1, Jae Young Oh1, Jung Eun Song1
1Division of Gastroenterology, Department of Internal Medicine, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea.
Abstract:
Mycoplasma pneumoniae (M. pneumoniae) is a major cause of community acquired respiratory infections. And it also causes a number of extrapulmonary manifestations including cardiovascular, dermatological, musculoskeletal, and hematological systems. But, acute hepatitis without lung involvement is rare in adults. Here, we report a case of 32-year-old man who presented with fever, chilling, myalgia, and headache. Biochemical analysis showed severely impaired liver function and leukopenia. Laboratory tests and liver biopsy demonstrated a hepatocellular pattern of M. pneumoniae-associated acute hepatitis. Clinical symptoms and laboratory parameters are improved rapidly under treatment with macrolide. Therefore, We recommend that phsycians should consider a possibility of M. pneumoniae infection in acute hepatitis without lung and extrapulmonary involvement, when other more frequent causes have been excluded.
Insights
Mycoplasma pneumoniae can cause acute hepatitis, even without lung symptoms. Early macrolide treatment rapidly improved this rare extrapulmonary manifestation in a patient.
Area of Science:
- Infectious Diseases
- Hepatology
- Pulmonology
Background:
- Mycoplasma pneumoniae is a common cause of respiratory infections.
- Extrapulmonary manifestations of Mycoplasma pneumoniae are known but typically involve cardiovascular, dermatological, musculoskeletal, and hematological systems.
- Acute hepatitis as an isolated presentation of Mycoplasma pneumoniae in adults is rare.
Observation:
- A 32-year-old male presented with fever, chills, myalgia, and headache.
- Biochemical analysis revealed severely impaired liver function and leukopenia.
- Laboratory tests and liver biopsy confirmed a hepatocellular pattern of acute hepatitis.
Findings:
- The patient was diagnosed with Mycoplasma pneumoniae-associated acute hepatitis.
- Hepatocellular injury pattern was identified.
- Rapid clinical and laboratory improvement was observed following macrolide treatment.
Implications:
- Mycoplasma pneumoniae should be considered in the differential diagnosis of acute hepatitis, particularly when lung or other extrapulmonary involvement is absent.
- Prompt diagnosis and treatment with macrolides can lead to rapid recovery.
- This case highlights the diverse clinical spectrum of Mycoplasma pneumoniae infections.
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