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Chest Infections: Fellow Case Report Poster - Chest Infections I |

Mycoplasma Pneumonia Causing Acute Hypoxemic Respiratory Failure

Matthew McLaughlin, DO; Jikerkhoun Simou, MD; Joshua Sill, MD
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Eastern Virginia Medical School, Norfolk, VA


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


Chest. 2016;150(4_S):117A. doi:10.1016/j.chest.2016.08.126
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SESSION TITLE: Fellow Case Report Poster - Chest Infections I

SESSION TYPE: Affiliate Case Report Poster

PRESENTED ON: Tuesday, October 25, 2016 at 01:30 PM - 02:30 PM

INTRODUCTION: Mycoplasma pneumonia is a common cause of pneumonia. Most patients run a benign course, however, rarely patients can present with severe acute respiratory failure.

CASE PRESENTATION: A 43-year-old male with history of tobacco use presented with 2-week history of progressive shortness of breath, fever, congestion, sore throat and productive cough. He progressed to severe hypoxemic respiratory failure requiring intubation. CT scan of the chest displayed diffuse nodular infiltrates in a miliary pattern (Figure 1). He underwent bronchoscopy with bronchoalveolar lavage. Cultures for bacteria, fungi and acid-fast bacilli were negative. He was initially started on broad-spectrum antibiotics but had progressively worsening hypoxemic respiratory failure requiring transfer to our tertiary care facility. On arrival, he was started on airway pressure release ventilation and levofloxacin. Serology was positive for cold agglutinins and was notable for IgM to Mycoplasma pneumonia at 7847 U/mL (positive is >770). He was successfully extubated on hospital day 3 and was transitioned to azithromycin to complete a 2-week course of antibiotics. Three weeks after discharge from the hospital repeat CT of the chest revealed resolution of the nodular miliary pattern (Figure 2).

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