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Mycoplasma pneumoniae COVID-19 Delta Variant Co-Infection Mimicking COVID-19 ARDS
James Crosby1, Sarah Semon1, Subramanya Shyam Ganti2
1HCA Healthcare/USF Morsani College of Medicine GME Programs, Tampa, FL, USA.
Abstract:
The Delta variant of COVID-19 has been associated with severe disease causing a surge in the second half of 2021. Atypical pathogens can be present in those in particular with severe ARDS and can contribute to excess morbidity and mortality. We must maintain a high level of suspicion for these pathogens as this can present an opportunity to dramatically improve the prognosis of a patient with COVID-19 ARDS. However, lend caution to Mycoplasma IgM serology as this can be a false-positive. If suspicion remains high for Mycoplasma pneumoniae infection, sputum polymerase chain reaction (PCR) for M pneumoniae is the gold standard for diagnosis. We present the case of a 42-year-old female with COVID-19 Delta variant presumed ARDS who had co-infection with M pneumoniae confirmed by endotracheal sputum aspirate PCR with rapidly improving oxygenation and extubation within 4 days of effective antibiotic therapy.
Insights
The COVID-19 Delta variant surge complicated ARDS cases. Early diagnosis of atypical pathogens like Mycoplasma pneumoniae, confirmed by PCR, improved patient outcomes with prompt antibiotic treatment.
Area of Science:
- Infectious Diseases
- Pulmonology
- Critical Care Medicine
Background:
- The COVID-19 Delta variant caused severe disease and acute respiratory distress syndrome (ARDS) surges.
- Atypical pathogens can co-infect patients with severe COVID-19 ARDS, increasing morbidity and mortality.
- High suspicion for co-infections is crucial for improving patient prognosis.
Observation:
- A 42-year-old female with COVID-19 Delta variant ARDS presented with atypical co-infection.
- Mycoplasma pneumoniae IgM serology can yield false-positive results, necessitating further diagnostic confirmation.
- Endotracheal sputum aspirate PCR is the gold standard for diagnosing Mycoplasma pneumoniae infection.
Findings:
- The patient was diagnosed with a co-infection of COVID-19 Delta variant and Mycoplasma pneumoniae.
- Diagnosis was confirmed via endotracheal sputum aspirate PCR for M. pneumoniae.
- Effective antibiotic therapy led to rapid improvement in oxygenation.
Implications:
- Prompt and accurate diagnosis of co-infections like Mycoplasma pneumoniae in COVID-19 ARDS is vital.
- PCR confirmation is essential, especially when serology results are questionable.
- Targeted antibiotic treatment can significantly improve outcomes and shorten recovery times in severe COVID-19 ARDS with co-infections.
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