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Mycoplasma pneumoniae pneumonia associated with severe neutropenia
Dounia Abbas1, Amanda Blot-Cossard1, Delphine Giusti2
1Department of Internal Medicine, Infectious Diseases, and Clinical Immunology, University Hospital of Reims, Reims, France.
Introduction:
Cold agglutinin haemolytic anaemia, aplastic anaemia, immune thrombocytopaenia and hemophagocytosis are well-established complications of Mycoplasma pneumoniae infection. In contrast, severe neutropenia has rarely been described.
Case Report:
We report the case of a 71-year-old with systemic lupus erythematosus who presented with severe febrile neutropenia (0.2G/L) and mild thrombocytopenia (75 G/L) revealing M. pneumoniae pneumonia. Erythema multiforme appeared secondary. Granulocyte autoantibodies were negative. Neutropenia and thrombocytopenia resolved within three days after azithromycin initiation.
Discussion:
Four other cases of M. pneumoniae pneumonia presenting with severe febrile neutropenia have been reported in the literature. They were associated with thrombocytopenia and/or anemia in all cases. Granulocyte autoantibodies were positive in 2 cases. This rare case highlights the importance of considering M. pneumoniae infection in the differential diagnosis of febrile neutropenia and illustrates that rapid resolution of neutropenia can be observed under antibiotic therapy alone.
Insights
Mycoplasma pneumoniae infection can cause severe febrile neutropenia, a rare but serious complication. Prompt antibiotic treatment with azithromycin led to rapid resolution of neutropenia in this case.
Area of Science:
- Hematology
- Infectious Diseases
- Pulmonology
Background:
- Mycoplasma pneumoniae infection is known to cause various hematologic complications like hemolytic anemia and immune thrombocytopenia.
- Severe neutropenia is an infrequently reported complication of Mycoplasma pneumoniae infection.
Purpose of the Study:
- To report a rare case of severe febrile neutropenia secondary to Mycoplasma pneumoniae pneumonia.
- To highlight the importance of considering Mycoplasma pneumoniae in the differential diagnosis of febrile neutropenia.
Main Methods:
- Case report of a 71-year-old patient with systemic lupus erythematosus presenting with severe febrile neutropenia and thrombocytopenia.
- Diagnosis of Mycoplasma pneumoniae pneumonia was established.
- Treatment with azithromycin was initiated.
Main Results:
- The patient presented with severe neutropenia (0.2G/L) and mild thrombocytopenia (75 G/L).
- Erythema multiforme developed secondary to the infection.
- Neutropenia and thrombocytopenia resolved rapidly within three days of azithromycin treatment.
Conclusions:
- This case adds to the limited literature on Mycoplasma pneumoniae-associated severe febrile neutropenia.
- Mycoplasma pneumoniae should be considered in the differential diagnosis of febrile neutropenia, especially when accompanied by thrombocytopenia or anemia.
- Antibiotic therapy alone can lead to rapid resolution of neutropenia in these cases.
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