title: Severe diffuse interstitial pneumonia due to Mycoplasma pneumoniae in a patient with respiratory insufficiency.
abstract: We report a 25-year-old man presenting with high fever, dyspnoea and somnolence. The presence of severe diffuse interstitial pneumonia with extrapulmonary symptoms, such as myositis and subclinical haemolysis, strongly suggested an infection by Mycoplasma pneumoniae. This diagnosis was supported by high titres of cold agglutinins and a positive Coombs test, and directly confirmed by specific IgM serological tests. After initiation of the appropriate antimicrobial treatment mechanical ventilation could be avoided and the patient showed a slow but complete clinical recovery. This diagnosis should be considered in any febrile patient with hypoxaemia and diffuse interstitial pneumonia, and rapid initiation of appropriate antibiotic treatment seems to be crucial for a favourable outcome.
authors.affiliation: Department of Internal Medicine, Isala Clinics, Sophia Hospital, PO Box 10400, 8000 GK Zwolle, the Netherlands. j.de.boer@isala.nl
authors.forename: J
authors.initials: J
authors.lastname: de Boer
authors.forename: S J A
authors.initials: SJ
authors.lastname: Aerdts
authors.forename: P H P
authors.initials: PH
authors.lastname: Groeneveld
mesh_terms: D000328:Adult; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification*; D011019:Pneumonia, Mycoplasma / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D013902:Radiography, Thoracic; D012131:Respiratory Insufficiency / Q000188:drug therapy / Q000209:etiology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005839:Gentamicins; D019980:Amoxicillin-Potassium Clavulanate Combination