Chronic Mycoplasma pneumoniae infection in a child after renal transplantation.
Mycoplasma pneumoniae has rarely been reported in renal transplant recipients. We present the case of a 10-yr-old boy with a six-month history of chronic cough, recurrent pyrexia, and weight loss three yr after RTx. The patient's post-transplant course was complicated by recurrence of NS that resolved with plasmapheresis and PTLD, which was successfully treated with an anti-CD20 monoclonal antibody. Chest X-ray showed a round mass-like lesion in the left upper lobe; MRT, PET, and bronchoscopy ruled out a PTLD. BAL fluid revealed M. pneumoniae-DNA. A three-wk course of macrolide therapy induced rapid recovery. We conclude that M. pneumoniae infection should be considered in immunosuppressed patients with long-lasting respiratory complaints and fever of unknown origin. Antibiotic treatment should be given for a minimum of three wk.
Schwerk
Nicolaus
N
Pediatric Pulmonology and Neonatology, Department of Pediatrics and Adolescent Medicine, Hannover Medical School, Hannover, Germany. schwerk.nicolaus@mh-hannover.de
Hartmann
Carolin
C
Baumann
Ulrich
U
Pape
Lars
L
Ehrich
Jochen H H
JH
Hansen
Gesine
G
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D002675:Child, Preschool; D002908:Chronic Disease; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis* / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D017963:Azithromycin