title: Combination therapy with immune-modulators and moxifloxacin on fulminant macrolide-resistant Mycoplasma pneumoniae infection: A case report.
abstract: This report entails a case of refractory pneumonia with a wild variety of extra-pulmonary manifestations due to macrolide-resistant Mycoplasma pneumoniae infection in a 7-year-old boy. The diagnosis was based on isolating M. pneumoniae through cultivation from the patient's bronchial aspirations at admission and the following susceptibility testing. Initial treatments consisting of a combination of azithromycin and standard-dosed methylprednisone (2 mg/kg) were completely nonresponsive and the patient's condition deteriorated rapidly. However, methylprednisone pulse therapy (20 mg/kg for 3 days, tapering within 1 month) and intravenous immunoglobulin (1 g/kg/day, two doses), in addition to moxifloxacin (10 mg/kg for 7 days) were remarkably effective and led to a favorable outcome without any observed side effects during inpatient hospitalization and outpatient follow-up.
authors.affiliation: Respiratory Department, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Yuelin
authors.initials: Y
authors.lastname: Shen
authors.forename: Jin
authors.initials: J
authors.lastname: Zhang
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Hu
authors.forename: Kunling
authors.initials: K
authors.lastname: Shen
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001372:Aza Compounds / Q000008:administration & dosage* / Q000627:therapeutic use; D002648:Child; D018450:Disease Progression; D004359:Drug Therapy, Combination; D024841:Fluoroquinolones; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D000077266:Moxifloxacin; D011019:Pneumonia, Mycoplasma / Q000150:complications / Q000188:drug therapy*; D020551:Pulse Therapy, Drug; D011804:Quinolines / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D011804:Quinolines; D000077266:Moxifloxacin; D008775:Methylprednisolone