Mycoplasma pneumonia and pulmonary embolism in a child due to acquired prothrombotic factors.
We report on a child with Mycoplasma pneumonia, who developed an unexplained new oxygen requirement. He was found to have an ileo-femoral thrombosis and an acute pulmonary embolus, with positive anti-phospholipid antibodies and acquired activated protein C resistance. These are both acquired risk factors for venous thrombosis. He was successfully anti-coagulated and well at follow-up with disappearance of the anti-phospholipid antibodies, and normalization of his activated protein C activity. Children who present with Mycoplasma infections who run an atypical course should be monitored closely for signs of thrombosis. Thrombosis formation should also be considered in those children with deteriorating respiratory status, but little change in radiographical findings. Children found to have developed thrombi should be investigated with a full thrombophilia screen to elicit both congenital and acquired risk factors, and should be anti-coagulated appropriately.
Brown
Sarah M N
SM
Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS trust, London, UK. sarahbrownmay@doctors.org.uk
Padley
Simon
S
Bush
Andrew
A
Cummins
David
D
Davidson
Simon
S
Buchdahl
Roger
R
D020016:Activated Protein C Resistance / Q000150:complications*; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D002648:Child; D006801:Humans; D008297:Male; D011019:Pneumonia, Mycoplasma / Q000150:complications*; D011655:Pulmonary Embolism / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology* / Q000276:immunology / Q000382:microbiology
D017152:Antibodies, Antiphospholipid