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Mycoplasma pneumoniae and Chlamydia pneumoniae Coinfection with Acute Respiratory Distress Syndrome: A Case Report
Meng-Ko Tsai1,2,3, Chao-Hung Lai4, Chris Tsai5
1Department of Internal Medicine, Division of Allergy, Immunology, and Rheumatology, Taichung Armed Forces Taichung General Hospital, Taichung 41152, Taiwan.
Abstract:
Community-acquired pneumonia caused by Mycoplasma pneumoniae or Chlamydia pneumoniae is usually mild. Mycoplasma pneumoniae-related and C. pneumoniae-related acute respiratory distress syndromes (ARDSs) are rare. Moreover, to our knowledge, there are no published reports on ARDS caused by M. pneumoniae and C. pneumoniae coinfection. Here, we report a case of an immunocompetent young woman who was co-infected with M. pneumoniae and C. pneumoniae and was started on treatment with piperacillin and clarithromycin. Two days later, she developed ARDS. She recovered rapidly following a change of antibiotic treatment to levofloxacin and was discharged on day 12. We conducted exome sequencing followed by alternative filtering to search for candidate ARDS-related genes. We identified an intronic variant of unknown significance within leucine-rich repeat-containing 16A (LRRC16A), a gene previously identified as a significant locus for platelet count with a possible role in ARDS. This is a rare case of ARDS in a young adult caused by M. pneumoniae and C. pneumoniae coinfection. This case suggests that ARDS in young adults may be correlated with variants in LRRC16A. This requires confirmation by further case reports.
Insights
Coinfection with Mycoplasma pneumoniae and Chlamydia pneumoniae can cause acute respiratory distress syndrome (ARDS) in young adults. A genetic variant in LRRC16A may be associated with ARDS development in these rare cases.
Area of Science:
- Infectious Diseases
- Pulmonology
- Genetics
Background:
- Community-acquired pneumonia from Mycoplasma pneumoniae or Chlamydia pneumoniae is typically mild.
- Acute respiratory distress syndrome (ARDS) associated with these pathogens is rare.
- Coinfection with Mycoplasma pneumoniae and Chlamydia pneumoniae leading to ARDS has not been previously reported.
Observation:
- A young, immunocompetent woman developed ARDS following coinfection with Mycoplasma pneumoniae and Chlamydia pneumoniae.
- Initial antibiotic treatment with piperacillin and clarithromycin was ineffective.
- Rapid recovery occurred after switching antibiotics to levofloxacin.
Findings:
- Exome sequencing identified an intronic variant in the LRRC16A gene.
- LRRC16A is a gene previously linked to platelet count and potentially ARDS.
- This case represents a rare instance of ARDS in a young adult due to M. pneumoniae and C. pneumoniae coinfection.
Implications:
- This case suggests a potential correlation between ARDS in young adults and variants in the LRRC16A gene.
- Further case reports are needed to confirm this association.
- The findings may inform future research into the genetic predispositions for ARDS.
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