Chest Infections: Chest Infections |

First Report of Severe Mycoplasma Hyorhinis Pneumonia in Adult: A Case Report FREE TO VIEW

Donghong Yang, MD; Lili Ren, PhD; Bingbing Lu, MD; Jianwei Wang, PhD; Zhancheng Gao, MD
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Peking University People's Hospital, Beijing, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A71. doi:10.1016/j.chest.2016.02.076
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SESSION TITLE: Chest Infections

SESSION TYPE: Case Report Slide

PRESENTED ON: Sunday, April 17, 2016 at 09:45 AM - 11:15 AM

INTRODUCTION: We describe the first reported case of severe pneumonia due to Mycoplasma hyorhinis in adult. This patient presented with severe respiratory failure and had to receive invasive positive pressure ventilation and extracorporeal membrane oxygenation (ECMO). Clinical routine microbiological testing and molecular methods did not show any evidence of any pathogens infection. Finally deep sequencing of BALF Prompt suspected Mycoplasma hyorhinis infection.

CASE PRESENTATION: This patients was a 64-year-old man with hypertension. He was admitted in November 2013 with a 6 days history of high fever, productive cough and dyspnea. Dry rales and wheezing were audible in lung fields on both sides. Laboratory findings were as follows: WBC 11.63×109/L, NEU% 93%, CRP 88.5 mg/dL, ALT 66 U/L, AST 93 IU/L, LDH 488 IU/L, CK 2792 IU/L, SCr 71U/L, K+ 3.41mmol/L, Na+ 134mmol/L. Arterial blood gas analysis demonstrated hypoxemia (PaO2 = 49mmHg) under the 5L/min of nasal oxygen inhalation). Chest radiography showed obvious exudation and consolidation in right lung (Fig. 1). The patient received high-flow mask oxygen support and was empirically treated with cefoperazone-sulbactam and moxifloxacin. However, his clinical condition deteriorated rapidly and had to receive invasive positive pressure ventilation and ECMO successively, while vancomycin, intravenous methylprednisolone and immunoglobulin (IVIG) were commenced. His symptoms, oxygenation and radiography were improved slowly at 8th day and was discharged at 39th day after admission. Admission blood culture, Smears and culture of the sputum and BALF, sera antibody detecting for atypical pathogens were all negative. Loop primer-mediated isothermal amplification (LAMP) for 12 common bacteria and Multiplex real-time PCR for 20 common viruses were also negative. Finally deep sequencing of BALF Prompt suspected Mycoplasma hyorhinis infection.

DISCUSSION: Mycoplasma hyorhinis causes respiratory tract infections, arthritis in swines. Meanwhile, It has been reported to be associated with some human cancer. However, it has not been reported to cause respiratory infections in humans until now. We describe a critical respiratory infection case probably due to Mycoplasma hyorhinis. This patient has not contact with live pigs, it is possible to contract the disease by eating meat from infected swines. moxifloxacin is potentially useful therapeutic strategy. More research is needed to determine how Mycoplasma hyorhinis may infect and cause pneumonia in people.

CONCLUSIONS: Mycoplasma hyorhinis is a potentially pathogen caused severe respiratory infection in people.

Reference #1: Huang S, Li JY, Wu J, et al. Mycoplasma infections and different human carcinomas. World J Gastroenterol. 2001 Apr;7(2):266-9.

DISCLOSURE: The following authors have nothing to disclose: Donghong Yang, Lili Ren, Bingbing Lu, Jianwei Wang, Zhancheng Gao

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