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Mycoplasma pneumoniae-associated diffuse alveolar haemorrhage: an atypical presentation of a prevalent pathogen
  1. Ryan D Slauer,
  2. Ahmad Mourad,
  3. Govind Krishnan and
  4. Colby Feeney
  1. Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
  1. Correspondence to Dr Ryan D Slauer; ryan.slauer{at}duke.edu

Abstract

A transgender man in his late teens presented with signs of multisystem disease, including hepatitis, mucositis and bone marrow suppression. He later developed dyspnoea, leucocytosis and bilateral pulmonary infiltrates on chest radiograph. He was treated for community-acquired pneumonia. After several days of treatment, he developed hypoxaemic respiratory failure due to bronchoscopy-confirmed diffuse alveolar haemorrhage (DAH). The differential diagnosis and workup were extensive, and he was ultimately treated with intravenous steroids and five sessions of plasmapheresis for a presumed autoimmune aetiology. Investigations were remarkable only for elevated IgM and IgG to Mycoplasma pneumoniae (MP). This case represents a rare presentation of multisystem disease secondary to MP in adults. Clinicians should consider Mycoplasma infection in cases of multisystem disease and observe for DAH even after initiation of appropriate therapy.

  • Pneumonia (infectious disease)
  • Pneumonia (respiratory medicine)
  • Vasculitis

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Footnotes

  • Twitter @slauerpowerhour

  • Contributors RDS was on the infectious disease consultation service that assisted in the care of the patient. He wrote the report and organised the efforts of the other authors. AM was also on the infectious disease consultation service. He edited the report and assisted with the literature review. GK was on the intensive care service that managed the patient. He edited and contributed to the writing of the report. CF was the hospitalist who originally cared for the patient prior to his transfer to the intensive care unit. She edited the report and advised on its composition.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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