title: Severe pneumonia by Mycoplasma as an adverse event of everolimus therapy in patients with tuberous sclerosis complex.
abstract: BACKGROUND
  Epilepsy is one of the most common symptoms in Tuberous Sclerosis Complex (TSC), appearing mainly in the first year of life and often resistant to therapy. Several studies have demonstrated the effectiveness of everolimus but its safety in children has not yet been well reported. We present two cases of severe pneumonia caused by Mycoplasma in two children receiving everolimus for epilepsy secondary to TSC.
  Both patients were admitted to the PICU for severe pneumonia with pleural effusion. One of them needed support with high concentration of oxygen and broad spectrum antibiotics and the other developed a septic shock with acute respiratory distress needing mechanical ventilation, vasoactive drugs, pleural drainage and broad-spectrum antibiotics. Everolimus was discontinued and in both patients Mycoplasma pneumoniae was identified by PCR. Both patients were discharged without sequelae.
  
  
  CONCLUSIONS
  Everolimus therapy for epilepsy in the context of TCS could be associated, as in these two cases, with severe bacterial infection by Mycoplasma.
authors.affiliation: Pediatric Intensive Care Medicine, Puerta del Mar University Hospital, Cádiz, Spain. Electronic address: carlosflogon@gmail.com.
authors.forename: J Carlos
authors.initials: JC
authors.lastname: Flores-González
authors.affiliation: Pediatric Intensive Care Medicine, Puerta del Mar University Hospital, Cádiz, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Estalella-Mendoza
authors.affiliation: Department of Maternal and Child Health Care and Radiology, University of Cádiz, Cádiz, Spain.
authors.forename: Alfonso María
authors.initials: AM
authors.lastname: Lechuga-Sancho
authors.affiliation: Pediatric Intensive Care Medicine, Puerta del Mar University Hospital, Cádiz, Spain.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Quintero-Otero
authors.affiliation: Pediatric Intensive Care Medicine, Puerta del Mar University Hospital, Cádiz, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rubio-Quiñones
authors.affiliation: Pediatric Intensive Care Medicine, Puerta del Mar University Hospital, Cádiz, Spain.
authors.forename: Arturo
authors.initials: A
authors.lastname: Hernández-González
authors.affiliation: Clinical Farmacology Unit, Puerta del Mar University Hospital, Cádiz, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Saldaña-Valderas
mesh_terms: D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000188:drug therapy / Q000209:etiology; D000068338:Everolimus / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007223:Infant; D008297:Male; D009175:Mycoplasma Infections / Q000209:etiology*; D011014:Pneumonia / Q000276:immunology* / Q000382:microbiology; D014402:Tuberous Sclerosis / Q000150:complications / Q000188:drug therapy*
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus
keywords: Adverse events; Children; Epilepsy; Everolimus; Mycoplasma; Pneumonia; Tuberous sclerosis complex