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Wang LP, Hu ZH, Jiang JS, Jin J. Serum inflammatory markers in children with Mycoplasma pneumoniae pneumonia and their predictive value for mycoplasma severity. World J Clin Cases 2024; 12:4940-4946. [DOI: 10.12998/wjcc.v12.i22.4940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/26/2024] [Accepted: 06/14/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Mycoplasma pneumoniae pneumonia (MPP) significantly impacts pediatric health, necessitating markers for early severe disease identification.
AIM To investigate the correlation between serum inflammatory marker and the severity of MPP in children.
METHODS A prospective study was carried out from January 2023 to November 2023. A total of 160 children with MPP who underwent treatment were selected: 80 had severe MPP and 80 had mild MPP. Clinical and laboratory data were collected at the time of hospital admission and during hospitalization. Receiver operating characteristic curves were utilized to assess the diagnostic and prognostic for severe MPP.
RESULTS Fever duration and length of hospitalization in pediatric patients with severe MPP exceeded those with mild MPP. The incidence of pleural effusion, lung consolidation, and bronchopneumonia on imaging was markedly elevated in the severe MPP cohort compared to the mild MPP cohort. In contrast to the mild cohort, there was a notable increase in C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate, lactic dehydrogenase, D-dimer, and inflammatory cytokines [interleukin (IL)-6, IL-8, IL-10 and tumor necrosis factor (TNF)-α] in the severe MPP group were significantly higher.
CONCLUSION Serum inflammatory markers (CRP, PCT, IL-6, D-dimer, IL-10 and TNF-α) were considered as predictors in children with severe MPP.
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Affiliation(s)
- Li-Ping Wang
- Department of Pediatrics, The First People's Hospital of Linping District, Hangzhou 310000, Zhejiang Province, China
| | - Zhong-Hua Hu
- Department of Pediatrics, The First People's Hospital of Linping District, Hangzhou 310000, Zhejiang Province, China
| | - Jun-Sheng Jiang
- Department of Pediatrics, The First People's Hospital of Linping District, Hangzhou 310000, Zhejiang Province, China
| | - Jie Jin
- Department of Pediatrics, Changzhou Children Hospital, Changzhou 213100, Jiangsu Province, China
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2
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Leng M, Yang J, Liu X. Macrolide-resistant mycoplasma pneumoniae infection in children observed during a period of high incidence in Henan, China. Heliyon 2024; 10:e33697. [PMID: 39040303 PMCID: PMC11260988 DOI: 10.1016/j.heliyon.2024.e33697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 06/12/2024] [Accepted: 06/25/2024] [Indexed: 07/24/2024] Open
Abstract
Objective Mycoplasma pneumoniae (Mp) is one of the major pathogens that causes respiratory tract infections, and macrolide resistance has increased rapidly in recent years due to the inappropriate use of macrolides in northeastern Asia. In the present study, we aimed to investigate Mp infection and macrolide resistance during a period of high incidence of Mp infection in Henan, China. Methods A total of 29473 suspected children with Mp infection were enrolled in the study from July to December 2023. Throat swab specimens were collected from all the study subjects, and real-time PCR was performed to detect the Mp-DNA and macrolide resistance-associated A2063G or A2064G mutations. Results The overall percentage of Mp-DNA-positive patients was 51.1 %, and the percentage of macrolide-resistant strains was 91 %. The rate of macrolide resistance remained stable from July to December. The Mp-DNA positivity rates among the different age groups from low to high were 0-1, 1-3, 3-6, 10-18 and 6-10 years. The macrolide resistance rate was the lowest in the 0-1 age group and highest in the 6-10 age group. No difference in the rate of macrolide resistance was observed between male and female children. Conclusions The macrolide resistance rate of Mp did not change during the investigated period of high incidence of infection, and no sex difference existed. The macrolide resistance rate of Mp was the lowest in children under 1 year old.
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Affiliation(s)
- Maodong Leng
- Department of Clinical Laboratory, Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, 450018, Henan, PR China
| | - Junmei Yang
- Department of Clinical Laboratory, Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, 450018, Henan, PR China
| | - Xinrui Liu
- Department of Clinical Laboratory, Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, 450018, Henan, PR China
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Yoshimoto K, Matsubara M, Kobayashi T, Nishio K. A Case of Mycoplasma Infection with an Atypical Presentation of Abducens Nerve Palsy, Erythema Multiforme and Polyarthritis without Respiratory Manifestations. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:36. [PMID: 38256298 PMCID: PMC10818581 DOI: 10.3390/medicina60010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/12/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024]
Abstract
Mycoplasma pneumoniae is a self-propagating microorganism that commonly causes respiratory tract infections. It can also cause a variety of extrapulmonary symptoms with or independently of respiratory symptoms, such as skin lesions, arthralgia, myalgia, hemolysis, cardiac lesions, gastrointestinal symptoms, and central nervous system lesions, which are rare manifestations reported in approximately 0.1% of cases. In this study, we present a unique case of Mycoplasma-related abducens nerve palsy, polyarthritis, and erythema multiforme without respiratory disease. The patient was a 69-year-old woman who presented to our hospital with a skin rash, fever, arthralgia, and diplopia without respiratory symptoms. Brain magnetic resonance imaging showed optic neuritis on the right side, suggesting the diplopia was caused by right abducens nerve palsy. However, the etiologies of abducens nerve palsy were not revealed by the physical examination, blood biochemistry tests, or bacteriological examinations, including the cerebrospinal fluid examination obtained at admission. Mycoplasma infection was suspected from erythema multiforme revealed by a skin biopsy and polyarthralgia, and it was finally diagnosed according to elevated Mycoplasma particle agglutination (PA) antibodies in paired serum. Though minocycline did not improve her diplopia, the daily administration of 30 mg of prednisolone gradually improved her symptoms, and the Mycoplasma PA antibody titer, which was regularly measured in the clinical course, also decreased, suggesting a relationship between Mycoplasma infection and abducens nerve palsy. This is the first case of isolated abducens nerve palsy, which was reported as the only central neurological symptom in an adult patient with Mycoplasma infection. The mechanism or pathogenesis of CNS manifestations caused by Mycoplasma pneumoniae remains to be elucidated, and further investigation is needed. Hence, Mycoplasma infection is a common disease. Clinicians should be aware of the diverse manifestations, including abducens nerve palsy, of Mycoplasma infection and should consider Mycoplasma infection even in the absence of typical respiratory symptoms.
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Affiliation(s)
- Kiyomi Yoshimoto
- Department of General Medicine, Nara Medical University Hospital, Kashihara 634-8522, Nara, Japan; (M.M.); (T.K.); (K.N.)
| | - Masaki Matsubara
- Department of General Medicine, Nara Medical University Hospital, Kashihara 634-8522, Nara, Japan; (M.M.); (T.K.); (K.N.)
| | - Tadanao Kobayashi
- Department of General Medicine, Nara Medical University Hospital, Kashihara 634-8522, Nara, Japan; (M.M.); (T.K.); (K.N.)
- Department of General Medicine, Uda City Hospital, Uda 633-0298, Nara, Japan
| | - Kenji Nishio
- Department of General Medicine, Nara Medical University Hospital, Kashihara 634-8522, Nara, Japan; (M.M.); (T.K.); (K.N.)
- Department of General Medicine, Uda City Hospital, Uda 633-0298, Nara, Japan
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Al Kindi H, Meredith LW, Al‐Jardani A, Sajina F, Al Shukri I, al Haj R, Alyaquobi F, Al Wahaibi A, Al Maani A. Time trend of respiratory viruses before and during the COVID-19 pandemic in severe acute respiratory virus infection in the Sultanate of Oman between 2017 and 2022. Influenza Other Respir Viruses 2023; 17:e13233. [PMID: 38098648 PMCID: PMC10719608 DOI: 10.1111/irv.13233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Severe acute respiratory illness (SARI) is a potentially lethal condition, necessitating thorough medical care. COVID-19 underscored the SARI threat, but other high-risk pathogens require monitoring alongside SARS-CoV-2. Oman instituted a comprehensive testing system to gauge the prevalence of these pathogens between 2017 and 2021, aiding resource allocation and public health responses to potential respiratory pathogen outbreaks. Methods Samples from SARI cases admitted to ICU were tested for pathogens using the Fast-Track Diagnostic (FTD) molecular assay, a respiratory virus panel (RVP) that tests for 21 pathogens, including 20 viruses, by qPCR. Results Between 2017 and 2022, ~30 000 samples were analysed using the RVP panel. Among SARI patients, 8%-42% tested positive for respiratory pathogens, with 4% showing multiple infectious agents, especially in children under 10. A drop in positivity during 2020-2021 can be attributed to SARS-CoV-2 control measures, followed by a rebound in infections in early 2022. Discussion The COVID-19 pandemic heightened awareness of respiratory pathogens' spread without adequate control measures. Influenza A/B, human rhinoviruses and respiratory syncytial virus constituted over 50% of severe acute respiratory illness cases in Oman over the past 5 years. During the pandemic, the incidence of these infections significantly declined, demonstrating the efficacy of COVID-19 prevention measures in reducing spread of other pathogens.
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Affiliation(s)
- Hanan Al Kindi
- Central Public Health Laboratories, Ministry of HealthDirectorate General for Disease Surveillance and ControlMuscatOman
| | - Luke William Meredith
- Department of Health EmergenciesWorld Health Organization Regional Office for the Eastern Mediterranean, Infectious Hazard ManagementCairoEgypt
| | - Amina Al‐Jardani
- Central Public Health Laboratories, Ministry of HealthDirectorate General for Disease Surveillance and ControlMuscatOman
| | - Fathima Sajina
- Central Public Health Laboratories, Ministry of HealthDirectorate General for Disease Surveillance and ControlMuscatOman
| | - Intisar Al Shukri
- Central Public Health Laboratories, Ministry of HealthDirectorate General for Disease Surveillance and ControlMuscatOman
| | - Rehan al Haj
- Central Public Health Laboratories, Ministry of HealthDirectorate General for Disease Surveillance and ControlMuscatOman
| | - Fatma Alyaquobi
- Department of Control, Ministry of HealthDirectorate General for Disease Surveillance and ControlMuscatOman
| | - Adil Al Wahaibi
- Department of Surveillance, Ministry of HealthDirectorate General for Disease Surveillance and ControlMuscatOman
| | - Amal Al Maani
- Ministry of HealthDirectorate General for Disease Surveillance and ControlMuscatOman
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5
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Marco L, Cambien G, Garcia M, Broutin L, Cateau E, Lariviere A, Castel O, Thevenot S, Bousseau A. [Respiratory infections: Additional transmission-based precautions in healthcare facilities]. Rev Mal Respir 2023; 40:572-603. [PMID: 37365075 DOI: 10.1016/j.rmr.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 05/04/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION In health care, measures against cross-transmission of microorganisms are codified by standard precautions, and if necessary, they are supplemented by additional precautions. STATE OF THE ART Several factors impact transmission of microorganisms via the respiratory route: size and quantity of the emitted particles, environmental conditions, nature and pathogenicity of the microorganisms, and degree of host receptivity. While some microorganisms necessitate additional airborne or droplet precautions, others do not. PROSPECTS For most microorganisms, transmission patterns are well-understood and transmission-based precautions are well-established. For others, measures to prevent cross-transmission in healthcare facilities remain under discussion. CONCLUSIONS Standard precautions are essential to the prevention of microorganism transmission. Understanding of the modalities of microorganism transmission is essential to implementation of additional transmission-based precautions, particularly in view of opting for appropriate respiratory protection.
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Affiliation(s)
- L Marco
- Unité d'hygiène hospitalière, département des agents infectieux, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France
| | - G Cambien
- Unité d'hygiène hospitalière, département des agents infectieux, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France; Inserm CIC 1402, université de Poitiers, CHU de Poitiers, 86021 Poitiers, France
| | - M Garcia
- Département des agents infectieux, laboratoire de virologie et mycobactériologie, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France; Laboratoire inflammation, tissus épithéliaux et cytokines, EA 4331, université de Poitiers, 86021 Poitiers, France
| | - L Broutin
- Département des agents infectieux, laboratoire de bactériologie, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France
| | - E Cateau
- Laboratoire écologie et biologie des interactions, UMR CNRS 7267, université de Poitiers, 86021 Poitiers, France; Département des agents infectieux, laboratoire de parasitologie et mycologie médicale, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France
| | - A Lariviere
- Département des agents infectieux, laboratoire de virologie et mycobactériologie, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France
| | - O Castel
- Unité d'hygiène hospitalière, département des agents infectieux, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France
| | - S Thevenot
- Unité d'hygiène hospitalière, département des agents infectieux, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France; Inserm CIC 1402, université de Poitiers, CHU de Poitiers, 86021 Poitiers, France
| | - A Bousseau
- Unité d'hygiène hospitalière, département des agents infectieux, pôle BIOSPHARM, CHU de Poitiers, 86021 Poitiers, France.
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Fan F, Lv J, Yang Q, Jiang F. Clinical characteristics and serum inflammatory markers of community-acquired mycoplasma pneumonia in children. THE CLINICAL RESPIRATORY JOURNAL 2023. [PMID: 37142438 PMCID: PMC10363789 DOI: 10.1111/crj.13620] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 02/10/2023] [Accepted: 04/05/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND To compare the demographic and clinical features, laboratory and imaging findings in mycoplasma pneumoniae pneumonia (MPP) children with non-MPP (NMPP) children and general MPP (GMPP) children with refractory MPP (RMPP) children and analysis the relationship with the severity of disease. METHODS The study included 265 children with MPP and 230 children with NMPP in the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University from 2020 to 2021. The children with MPP included RMPP (n = 85) and GMPP (n = 180). Demographic and clinical characteristics, laboratory and imaging findings of all children were measured as baseline data within 24 h after admission and the differences between MPP and NMPP, RMPP and GMPP patients were compared. ROC curves were used to evaluate the diagnostic and predictive value of different indicators for RMPP. RESULTS Fever duration and hospital stay in children with MPP were longer than those with NMPP. The number of patients with imaging features of pleural effusion, lung consolidation and bronchopneumonia in MPP group was significantly higher than that in NMPP group. Compared with NMPP group, the levels of C-reactive protein (CRP), procalcitonin (PCT), serum amyloid A (SAA), erythrocyte sedimentation rate (ESR), lactic dehydrogenase (LDH), prothrombin time (PT), fibrinogen (FIB) and D-dimer and inflammatory cytokines (interleukin [IL]-6, IL-8, IL-10 and IL-1β) in MPP group were significantly higher (P < 0.05). The clinical symptoms and pulmonary imaging findings were more severe in RMPP group. The levels of white blood cell (WBC), CRP, PCT, SAA, ESR, alanine aminotransferase (ALT), LDH, ferritin, PT, FIB, D-dimer and inflammatory cytokines in RMPP group were higher than those in GMPP group. There was no significant difference in the level of lymphocyte subsets between the RMPP and GMPP group. IL-6, IL-10, LDH, PT, D-dimer and lung consolidation were independent risk factors for RMPP. IL-6 levels and LDH activity were good predictors of RMPP. CONCLUSION In conclusion, there were differences in clinical characteristics and serum inflammatory markers between MPP group and NMPP group, RMPP group and GMPP group. IL-6, IL-10, LDH, PT and D-dimer can be used as predictive indicators for RMPP.
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Affiliation(s)
- Fei Fan
- Department of Paediatrics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Jun Lv
- Department of Paediatrics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Qianyuan Yang
- Department of Paediatrics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Fei Jiang
- Department of Paediatrics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
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7
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Insight into the Pathogenic Mechanism of Mycoplasma pneumoniae. Curr Microbiol 2023; 80:14. [PMID: 36459213 PMCID: PMC9716528 DOI: 10.1007/s00284-022-03103-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 10/28/2022] [Indexed: 12/04/2022]
Abstract
Mycoplasma pneumoniae, an obligate parasitic pathogen without cell wall, can cause severe upper and lower respiratory tract symptoms. It is the pathogen of human bronchitis and walking pneumonia, and named community-acquired pneumonia. In addition to severe respiratory symptoms, there are clinical extrapulmonary manifestations in the skin, brain, kidney, musculoskeletal, digestive system, and even blood system after M. pneumoniae infection. Hereby, we comprehensively summarized and reviewed the intrapulmonary and extrapulmonary pathogenesis of M. pneumoniae infection. The pathogenesis of related respiratory symptoms caused by M. pneumoniae is mainly adhesion damage, direct damage including nutrient predation, invasion and toxin, cytokine induced inflammation damage and immune evasion effect. The pathogenesis of extrapulmonary manifestations includes direct damage mediated by invasion and inflammatory factors, indirect damage caused by host immune response, and vascular occlusion. The intrapulmonary and extrapulmonary pathogenic mechanisms of M. pneumoniae infection are independent and interrelated, and have certain commonalities. In fact, the pathogenic mechanisms of M. pneumoniae are complicated, and the specific content is still not completely clear, further researches are necessary for determining the detailed pathogenesis of M. pneumoniae. This review can provide certain guidance for the effective prevention and treatment of M. pneumoniae infection.
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Li X, Yang S, Tan Z, Chen L, Hu X. Clinical analysis of hospital acquired mycoplasma pneumoniae infection after cardiac surgery: a case series. J Thorac Dis 2022; 14:4763-4772. [PMID: 36647462 PMCID: PMC9840008 DOI: 10.21037/jtd-22-1491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 11/24/2022] [Indexed: 12/15/2022]
Abstract
Background Mycoplasma pneumoniae (MP) is a common pathogen of community-acquired respiratory infections. The clinical characteristics hospital-acquired MP infections are rarely reported in the literature. Our ward is mainly responsible for the management of patients during the perioperative period of cardiac surgery. Several patients had fever during the improvement of their condition after cardiac surgery, and the effect of upgrading antibiotics and increasing the antibacterial spectrum was not good. Methods Using inpatient data of Guangdong Provincial People's Hospital, we conducted a retrospective case series study of hospital-acquired MP infection after cardiac surgery from January 2015 to December 2020 to investigate the clinical characteristics. Clinical data was extracted from patients with a confirmed diagnosis of MP infection after >48 hours of hospitalization. All analyses for this study were descriptive. Data were expressed as mean ± standard deviation (SD), median with range or number with percentage as appropriate. Results We totally included 22 patients. The time of onset of hospital-acquired MP infection after surgery was 23.32±12.57 days, and the duration of antibiotic use before the onset of infection was 4-40 days. Both fever and sore throat were the main symptoms of nosocomial MP infection, and the rash was the most common physical sign. Laboratory tests were normal for peripheral blood leukocyte count and procalcitonin in most patients (17 cases), while the lymphocyte count was decreased in 10 cases. A single serum anti-MP antibody titer ≥1:160 combined with clinical manifestations and imaging helped confirm nosocomial MP infection, although a double serum anti-MP antibody (four-fold change in titer) wasn't seen. With quinolone therapy, such as levofloxacin, all the patients' temperature gradually returned to normal and were discharged uneventfully. Conclusions Patients after cardiac surgery should be aware of the presence of hospital-acquired MP infection when they develop new fever accompanied by atypical bacterial infection signs such as sore throat and rash during treatment. In such cases, changes in MP antibody titers need to be monitored and anti-MP therapy is required.
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Affiliation(s)
- Xiaoming Li
- Department of General Practice, Guangdong People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shifang Yang
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhidan Tan
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lian Chen
- Department of General Practice, Guangdong People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiangming Hu
- Department of Fever Clinics, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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KC O, Dahal PH, Koirala M, NtemMensah AD. Rhabdomyolysis and Neurological Manifestation With Progressive Weakness in a Young Adult: A Rare Extrapulmonary Presentation of Mycoplasma Pneumoniae. Cureus 2021; 13:e20552. [PMID: 35103132 PMCID: PMC8770897 DOI: 10.7759/cureus.20552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 12/03/2022] Open
Abstract
Mycoplasma pneumoniae (M. pneumoniae) is a common cause of community-acquired pneumonia. It has been associated with many extrapulmonary manifestations that can present even in the absence of pulmonary signs and symptoms. Rhabdomyolysis and central nervous system (CNS) manifestations are rare extrapulmonary manifestations. These are infrequently reported in adults. We present a case of a healthy 32-year-old male who initially presented with signs and symptoms of community-acquired pneumonia and was treated with antibiotics. However, he continued to have generalized malaise, night sweats, diffuse joint pain, and myalgias and was subsequently noted to have rhabdomyolysis with elevated creatine kinase (CK) and myoglobin levels. Rhabdomyolysis was attributed to M. pneumoniae based on the recent history of upper respiratory tract infection and M. pneumoniae immunoglobulin M (IgM) serology positivity along with high M. pneumoniae IgG titer. The other causes of rhabdomyolysis were diligently excluded based on patient history and laboratory and clinical data. This immune-mediated rhabdomyolysis improved with intravenous hydration, doxycycline, and prednisone therapy. However, the patient developed progressive weakness with neuropathy, which required treatment with intravenous immune globulin (IVIG). This case highlights the need to maintain a high index of suspicion for rare extrapulmonary manifestations of mycoplasma infection, which could be life-threatening or cause significant morbidity; and in cases of severe extrapulmonary manifestations, the appropriate use of immunosuppressive/immunomodulatory therapy may lead to a better outcome.
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Liu Z, Huo JH, Dong WT, Sun GD, Li FJ, Zhang YN, Qin ZW, Pengna J, Wang WM. A Study Based on Metabolomics, Network Pharmacology, and Experimental Verification to Explore the Mechanism of Qinbaiqingfei Concentrated Pills in the treatment of Mycoplasma Pneumonia. Front Pharmacol 2021; 12:761883. [PMID: 34803705 PMCID: PMC8599429 DOI: 10.3389/fphar.2021.761883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/27/2021] [Indexed: 12/13/2022] Open
Abstract
Qinbaiqingfei concentrated pills (QB) are a commonly used medicine for the treatment of mycoplasma pneumonia in China, and the mechanism of action of QB needs to be studied further. Therefore, we use a combination of metabolomics and network pharmacology to clarify the mechanism of QB. Nontarget metabolomics studies were performed on rat serum, urine, and lung tissues, and 56 therapeutic biomarkers were found. Subsequently, the components of QB absorbed into the blood and lung tissues were clarified, and based on this finding, the core target of network pharmacology was predicted. The enrichment analysis of biomarkers–genes finally confirmed their close relationship with the NF-κB signaling pathway. By western blotting expression of the proteins in the lung tissue–related signaling pathways, it is finally confirmed that QB inhibits the NF-κB signaling pathway through SIRT1, IL-10 and MMP9, CTNNB1, EGFR, and other targets. It plays a role in regulating immunity, regulating metabolism, and treating diseases.
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Affiliation(s)
- Zheng Liu
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Jin-Hai Huo
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Wen-Ting Dong
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Guo-Dong Sun
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Feng-Jin Li
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Ya-Nan Zhang
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Zhi-Wei Qin
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
| | - Jiang Pengna
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Wei-Ming Wang
- Heilongjiang Academy of Chinese Medicine, Institute of Chinese Materia Medica, Harbin, China
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11
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Matsui H, Sugimura M, Inoue-Tsuda M, Iwabuchi K, Hanaki H. Development of an immunochromatographic test for the detection of Mycoplasma pneumoniae GroES antigen. J Microbiol Methods 2021; 191:106359. [PMID: 34744002 DOI: 10.1016/j.mimet.2021.106359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/12/2021] [Accepted: 10/27/2021] [Indexed: 11/25/2022]
Abstract
Mycoplasma pneumoniae frequently causes community-acquired pneumonia in children; β-lactam antibiotics are ineffective against this bacterium because of its lack of a cell wall. Hence, a rapid and simple detection method is required to ensure appropriate treatment. In this study, we developed a rapid and simple immunochromatography-based detection method using monoclonal antibodies that react with the co-chaperone GroES of M. pneumoniae. Mice were immunized with recombinant GroES, and hybridoma cells producing anti-GroES monoclonal antibodies were established. For the development of the immunochromatographic test, antibody pairs with superior reactivity and specificity were selected. The developed immunochromatographic test could detect 0.1 ng/mL of recombinant GroES within 20 min. Moreover, no cross-reaction was observed with other microorganisms, including six Mycoplasma species, 20 other bacterial species, and one yeast species. Macrolide-resistant and -susceptible M. pneumoniae clinical isolates were detected at approximately 104 to 105 colony-forming units/mL. The study indicates that immunochromatographic tests targeting GroES are useful for rapid and simple detection of M. pneumoniae.
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Affiliation(s)
- Hidehito Matsui
- Ōmura Satoshi Memorial Institute, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo 108-8641, Japan
| | - Makoto Sugimura
- Ōmura Satoshi Memorial Institute, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo 108-8641, Japan
| | - Megumi Inoue-Tsuda
- Ōmura Satoshi Memorial Institute, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo 108-8641, Japan
| | - Kazuya Iwabuchi
- Department of Immunology, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara-shi, Kanagawa 252-0373, Japan
| | - Hideaki Hanaki
- Ōmura Satoshi Memorial Institute, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo 108-8641, Japan.
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12
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Mizutani M, Sasajima Y, Miyata M. Force and Stepwise Movements of Gliding Motility in Human Pathogenic Bacterium Mycoplasma pneumoniae. Front Microbiol 2021; 12:747905. [PMID: 34630372 PMCID: PMC8498583 DOI: 10.3389/fmicb.2021.747905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/24/2021] [Indexed: 11/23/2022] Open
Abstract
Mycoplasma pneumoniae, a human pathogenic bacterium, binds to sialylated oligosaccharides and glides on host cell surfaces via a unique mechanism. Gliding motility is essential for initiating the infectious process. In the present study, we measured the stall force of an M. pneumoniae cell carrying a bead that was manipulated using optical tweezers on two strains. The stall forces of M129 and FH strains were averaged to be 23.7 and 19.7 pN, respectively, much weaker than those of other bacterial surface motilities. The binding activity and gliding speed of the M129 strain on sialylated oligosaccharides were eight and two times higher than those of the FH strain, respectively, showing that binding activity is not linked to gliding force. Gliding speed decreased when cell binding was reduced by addition of free sialylated oligosaccharides, indicating the existence of a drag force during gliding. We detected stepwise movements, likely caused by a single leg under 0.2-0.3 mM free sialylated oligosaccharides. A step size of 14-19 nm showed that 25-35 propulsion steps per second are required to achieve the usual gliding speed. The step size was reduced to less than half with the load applied using optical tweezers, showing that a 2.5 pN force from a cell is exerted on a leg. The work performed in this step was 16-30% of the free energy of the hydrolysis of ATP molecules, suggesting that this step is linked to the elementary process of M. pneumoniae gliding. We discuss a model to explain the gliding mechanism, based on the information currently available.
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Affiliation(s)
- Masaki Mizutani
- Graduate School of Science, Osaka City University, Osaka, Japan
| | - Yuya Sasajima
- Graduate School of Science, Osaka City University, Osaka, Japan
| | - Makoto Miyata
- Graduate School of Science, Osaka City University, Osaka, Japan.,The OCU Advanced Research Institute for Natural Science and Technology (OCARINA), Osaka City University, Osaka, Japan
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13
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Dawood H, Nasir S, Khair RM, Dawood M. Infective Endocarditis Secondary to Mycoplasma pneumoniae. Cureus 2021; 13:e17461. [PMID: 34603862 PMCID: PMC8475736 DOI: 10.7759/cureus.17461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 11/05/2022] Open
Abstract
Mycoplasma pneumoniae (MP) is a gram-positive bacterium most commonly associated with community-acquired pneumonia in adults. It can also involve other systems of the body. Cardiovascular complications include pericarditis, myocarditis, congestive cardiac failure, and, rarely, infective endocarditis. We report a case of infective endocarditis secondary to MP infection in an adult. We treated our patient with doxycycline, which showed significant improvement.
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Affiliation(s)
| | - Saad Nasir
- Internal Medicine, Aga Khan University Hospital, Karachi, PAK
| | - Reem M Khair
- Internal Medicine, Beaumont Hospital, Dublin, IRL
| | - Mustafa Dawood
- Nephrology, Emory University School of Medicine, Atlanta, USA
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14
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Liu L, Maharjan S, Sun JL, Li YC, Cheng HJ. Prevalence and clinical characteristics of septicemia in children with Mycoplasma pneumoniae pneumonia. J Int Med Res 2021; 49:3000605211021733. [PMID: 34167353 PMCID: PMC8236790 DOI: 10.1177/03000605211021733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Mycoplasma pneumoniae (MP) pneumonia in children can be challenging to treat, and the impact of MP blood infection is unclear. The present study aims to determine the prevalence and clinical characteristics of MP septicemia among pediatric patients. Methods Children hospitalized at our center for MP pneumonia between October 2017 and June 2018 were included. Healthy controls visiting our outpatient clinic for regular physical examinations were also enrolled. MP was detected by real-time polymerase chain reaction (qPCR) analysis of plasma and peripheral blood mononuclear cell (PBMC) samples. Results Sixty-one children with MP pneumonia and 30 healthy children were included. Among children with MP infection, 31 (50.8%) were positive for MP by qPCR (19 in plasma samples, 8 in PBMC samples, and 4 in both). All healthy controls were negative for MP by qPCR. Conclusions The prevalence of MP septicemia in children with MP pneumonia is moderate. However, detection of MP in blood samples may have limited clinical value for guiding treatment.
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Affiliation(s)
- Li Liu
- Department of Pediatric Pulmonology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Shobha Maharjan
- Department of Pediatric Pulmonology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jia-Liang Sun
- Department of Pediatric Pulmonology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Yan-Chun Li
- Department of Pediatric Pulmonology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Huan-Ji Cheng
- Department of Pediatric Pulmonology, The First Hospital of Jilin University, Changchun, Jilin Province, China
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15
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Bi Y, Ma Y, Zhuo J, Zhang L, Yin L, Sheng H, Luan J, Li T. Risk of Mycoplasma pneumoniae-related hepatitis in MP pneumonia pediatric patients: a predictive model construction and assessment. BMC Pediatr 2021; 21:287. [PMID: 34154565 PMCID: PMC8218438 DOI: 10.1186/s12887-021-02732-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A predictive model for risk of Mycoplasma pneumoniae (MP)-related hepatitis in MP pneumonia pediatric patients can improve treatment selection and therapeutic effect. However, currently, no predictive model is available. METHODS Three hundred seventy-four pneumonia pediatric patients with/without serologically-confirmed MP infection and ninety-three health controls were enrolled. Logistic regressions were performed to identify the determinant variables and develop predictive model. Predictive performance and optimal diagnostic threshold were evaluated using area under the receiver operating characteristic curve (AUROC). Stratification analysis by age and MP-IgM titer was used to optimize model's clinical utility. An external validation set, including 84 MP pneumonia pediatric patients, was used to verify the predictive efficiency. After univariate analysis to screen significant variables, monocyte count (MO), erythrocyte distribution width (RDW) and platelet count (PLT) were identified as independent predictors in multivariate analysis. RESULTS We constructed MRP model: MO [^109/L] × 4 + RDW [%] - PLT [^109/L] × 0.01. MRP achieved an AUROC of 0.754 and the sensitivity and specificity at cut-off value 10.44 were 71.72 and 61.00 %, respectively in predicting MP-related hepatitis from MP pneumonia. These results were verified by the external validation set, whereas it merely achieved an AUROC of 0.540 in pneumonia without MP infection. The AUROC of MRP was 0.812 and 0.787 in infants and toddlers (0-36 months) and low MP-IgM titer subgroup (1:160-1:320), respectively. It can achieve an AUROC of 0.804 in infants and toddler with low MP-IgM titer subgroup. CONCLUSIONS MRP is an effective predictive model for risk of MP-related hepatitis in MP pneumonia pediatric patients, especially infants and toddlers with low MP-IgM titer.
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Affiliation(s)
- Yuna Bi
- Department of Pediatrics, Shandong Provincial Maternal and Child Health Care Hospital, Cheeloo College of Medicine, Shandong University, 238#, Jing 10 East Road, Jinan, Shandong, China
| | - Yan Ma
- Department of Pediatrics, Cheeloo College of Medicine, Shandong Provincial Third Hospital, Shandong University, 12#, Wuyingshan Middle Road, Jinan, 250014, Shandong, China
| | - Jinhua Zhuo
- Department of Clinical Laboratory, Cheeloo College of Medicine, Shandong Provincial Third Hospital, Shandong University, 12#, Wuyingshan Middle Road, Jinan, 250014, Shandong, China
| | - Lili Zhang
- Department of Pediatrics, Affiliated Hospital of Yangzhou University, 45#, Taizhou Road, Yangzhou, Jiangsu, China
| | - Liyan Yin
- Department of Pediatrics, Cheeloo College of Medicine, Shandong Provincial Third Hospital, Shandong University, 12#, Wuyingshan Middle Road, Jinan, 250014, Shandong, China
| | - Hongling Sheng
- Department of Pediatrics, Cheeloo College of Medicine, Shandong Provincial Third Hospital, Shandong University, 12#, Wuyingshan Middle Road, Jinan, 250014, Shandong, China
| | - Jie Luan
- Department of Pediatrics, Cheeloo College of Medicine, Shandong Provincial Third Hospital, Shandong University, 12#, Wuyingshan Middle Road, Jinan, 250014, Shandong, China
| | - Tao Li
- Department of Infectious Diseases, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324#, Jing 5 Road, 250021, Jinan, China.
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16
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Naraki K, Rezaee R, Karimi G. A review on the protective effects of naringenin against natural and chemical toxic agents. Phytother Res 2021; 35:4075-4091. [PMID: 33724584 DOI: 10.1002/ptr.7071] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/13/2021] [Accepted: 02/23/2021] [Indexed: 12/14/2022]
Abstract
Naringenin (NRG), as a flavanone from flavonoids family, is widely found in grapefruit, lemon tomato, and Citrus fruits. NRG has shown strong anti-inflammatory and antioxidant activities in body organs via mechanisms such as enhancement of glutathione S-transferase (GST), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) activity, but reduction of serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and malondialdehyde (MDA). Furthermore, NRG anti-apoptotic potential was indicated to be mediated by regulating B-cell lymphoma (Bcl-2), Bcl-2-associated X protein (Bax) and caspase3/9. Overall, these properties make NRG a highly fascinating compound with beneficial pharmacological effects. Based on the literature, NRG-induced protective effects against toxicities produced by natural toxins, pharmaceuticals, heavy metals, and environmental chemicals, were mainly mediated via suppression of lipid peroxidation, oxidative stress (through boosting the antioxidant arsenal), and inflammatory factors (e.g., TNF-α, interleukin [IL]-6, IL-10, and IL-12), and activation of PI3K/Akt and MAPK survival signaling pathways. Despite considerable body of evidence on protective properties of NRG against a variety of toxic compounds, more well-designed experimental studies and particularly, clinical trials are required before reaching a concrete conclusion. The present review discusses how NRG protects against the above-noted toxic compounds.
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Affiliation(s)
- Karim Naraki
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ramin Rezaee
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gholamreza Karimi
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.,Pharmaceutical Research Center Institute of Pharmaceutical Technology, Mashhad University of Medical Sciences, Mashhad, Iran
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17
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彭 力, 钟 礼, 黄 振, 黎 燕, 张 兵. [Clinical features of children with Mycoplasma pneumoniae pneumonia and peripheral lymphocytopenia]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:74-77. [PMID: 33476541 PMCID: PMC7818155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/13/2020] [Indexed: 08/06/2024]
Abstract
OBJECTIVE To study the clinical features of children with Mycoplasma pneumoniae pneumonia (MPP) and peripheral lymphocytopenia. METHODS A total of 310 MPP children who were hospitalized and underwent bronchoalveolar lavage from June 2018 to June 2019 were enrolled and divided into two groups: simple MPP group with 241 children (without peripheral lymphocytopenia) and MPP + peripheral lymphocytopenia group with 69 children. The two groups were compared in terms of clinical data and treatment outcome. RESULTS Compared with the simple MPP group, the MPP + peripheral lymphocytopenia group had significantly longer duration of fever and length of hospital stay and significant increases in C-reactive protein, lactate dehydrogenase, and Mycoplasma pneumoniae DNA copies in bronchoalveolar lavage fluid (P < 0.05). Compared with the simple MPP group, the MPP + peripheral lymphocytopenia group had significantly higher incidence rates of intrapulmonary consolidation, extrapulmonary complications, and serious lesions under bronchoscopy (erosion or sputum bolt) and a significantly higher proportion of patients with severe MPP (P < 0.05). CONCLUSIONS Children with MPP and peripheral lymphocytopenia tend to have more severe immunologic injury. Peripheral blood lymphocyte count may be used to evaluate the severity of MPP.
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Affiliation(s)
- 力 彭
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 礼立 钟
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 振 黄
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 燕 黎
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 兵 张
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
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18
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彭 力, 钟 礼, 黄 振, 黎 燕, 张 兵. [Clinical features of children with Mycoplasma pneumoniae pneumonia and peripheral lymphocytopenia]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:74-77. [PMID: 33476541 PMCID: PMC7818155 DOI: 10.7499/j.issn.1008-8830.2009012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/13/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To study the clinical features of children with Mycoplasma pneumoniae pneumonia (MPP) and peripheral lymphocytopenia. METHODS A total of 310 MPP children who were hospitalized and underwent bronchoalveolar lavage from June 2018 to June 2019 were enrolled and divided into two groups: simple MPP group with 241 children (without peripheral lymphocytopenia) and MPP + peripheral lymphocytopenia group with 69 children. The two groups were compared in terms of clinical data and treatment outcome. RESULTS Compared with the simple MPP group, the MPP + peripheral lymphocytopenia group had significantly longer duration of fever and length of hospital stay and significant increases in C-reactive protein, lactate dehydrogenase, and Mycoplasma pneumoniae DNA copies in bronchoalveolar lavage fluid (P < 0.05). Compared with the simple MPP group, the MPP + peripheral lymphocytopenia group had significantly higher incidence rates of intrapulmonary consolidation, extrapulmonary complications, and serious lesions under bronchoscopy (erosion or sputum bolt) and a significantly higher proportion of patients with severe MPP (P < 0.05). CONCLUSIONS Children with MPP and peripheral lymphocytopenia tend to have more severe immunologic injury. Peripheral blood lymphocyte count may be used to evaluate the severity of MPP.
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Affiliation(s)
- 力 彭
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 礼立 钟
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 振 黄
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 燕 黎
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
| | - 兵 张
- />湖南省人民医院儿童医学中心儿童呼吸病学湖南省重点实验室, 湖南长沙 410005Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China
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19
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Pouladi I, Mirnejad R, Rostampur S, Viesy S, Niakan M. Molecular Detection and Evaluation of MLـ Resistance M. Pneumoniae Associated with Mutation in 23S RNA Gene among Iranian Patients with Respiratory Infections. Rep Biochem Mol Biol 2020; 9:223-229. [PMID: 33178873 DOI: 10.29252/rbmb.9.2.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Background Mycoplasma pneumoniae is a common cause of community-acquired pneumonia. The global increased resistance of M. pneumoniae strains to macrolide (ML) has become a worrisome health problem. The widespread use of these medications has led to increased rate of reported ML-resistant M. pneumoniae (MRMP) throughout the world. This study was aimed to evaluate the resistance of M. pneumoniae against erythromycin due to mutations in the 23S rRNA gene of patients with respiratory infections in Iran. Methods In this study, 100 samples of throat swab from a patient with respiratory problems were collected. After the cultured of all samples in M. pneumonia-specific PPLO medium, PCR technique was performed with specific primers. Afterwards, the broth micro-dilution MIC assay was employed. Finally, the PCR product of the 23S rRNA gene was sequenced to detect mutations of domain V in 23S rRNA gene of MRMP. Results It was found that 17 cases (17%) were positive for mycoplasma genus and six cases (6%) positive for M. pneumoniae species. Also, analysis of the sequence of 23S rRNA gene, revealed that one of the samples had mutations at positions A2431G and G2491A. All positive samples M. pneumoniae with 23S rRNA gene were sensitive to erythromycin. Conclusion These use of these antibiotics should be limited to prevent the emergence of MRMP in Iran.
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Affiliation(s)
- Iman Pouladi
- Department of Medical Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Reza Mirnejad
- Molecular Biology Research Center, System biology and Poisoning institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Susan Rostampur
- Student Research Committee of faculty paramedicine, Iran University of Medical Sciences, Tehran, Iran
| | - Soghra Viesy
- Department of Medical parasitology, Faculty of paramedicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Mohammad Niakan
- Department of Medical Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
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20
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Superoxide dismutase 3 as an inflammatory suppressor in A549 cells infected with Mycoplasma pneumoniae. J Biosci 2020. [DOI: 10.1007/s12038-020-00105-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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21
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Xu W, Yang H, Liu H, Tang X, Xu H, Li H, Zhao S. Bronchoalveolar lavage T cell cytokine profiles and their association with lung function in children with Mycoplasma pneumoniae -associated bronchiolitis obliterans. Pediatr Pulmonol 2020; 55:2033-2040. [PMID: 32478954 DOI: 10.1002/ppul.24882] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/17/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Mycoplasma pneumoniae (M. pneumoniae) infection may progress to bronchiolitis obliterans (BO), with an underlying chronic inflammatory process. The aim of this study was to investigate the cytokine profiles in pulmonary T-lymphocytes and their associations with lung function in patients with BO following M. pneumoniae infection. METHODS Bronchoalveolar lavage (BAL) samples were obtained from 10 controls and 18 children with M. pneumoniae-associated BO. We analyzed the BAL T cells for interferon (IFN)-γ, interleukin (IL)-4, IL-9, IL-17, CD25, and Foxp3 by intercellular flow cytometry. The associations with T-cell subpopulations and lung function parameters were determined. RESULTS In BAL fluid, significantly increased proportions of T-helper 1 (Th1), Th17, and Tc1 cells were found in M. pneumoniae-associated BO patients when compared with controls. The percentages of Th17 cells showed correlations with forced expiratory volume in 1 second % predicted value (r = -0585; P < .05) and forced expiratory flow at 25% to 75% (FEF25%-75% ) % predicted value (r = -.618; P < .01). Higher proportions of Tc1 (r = -.488; P < .05) and Tc17 (r = -.542; P < .05) were significantly correlated with a reduced FEF25%-75% % predicted value in M. pneumoniae-associated BO patients. CONCLUSIONS Our comprehensive cytokines analysis of BAL T cells revealed correlations of IL-17-producing and IFN-γ-producing T cells with lung function, suggesting that increased T-cell subpopulations may play a role in M. pneumoniae-associated BO progression.
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Affiliation(s)
- Weihan Xu
- Department 2 of Respiratory Medicine, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Haiming Yang
- Department 2 of Respiratory Medicine, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Hui Liu
- Department 2 of Respiratory Medicine, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Xiaolei Tang
- Department 2 of Respiratory Medicine, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Hui Xu
- Department 2 of Respiratory Medicine, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Huimin Li
- Department 2 of Respiratory Medicine, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Shunying Zhao
- Department 2 of Respiratory Medicine, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
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22
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Big Mohammadi H, Pouladi I, Zolfaghari MR, Niakan M. The Prevalence of 23S rRNA Mutations in ML-Resistant M. pneumoniae Isolates to Clarithromycin in Patients with Respiratory Infections. Rep Biochem Mol Biol 2020; 9:156-162. [PMID: 33178864 PMCID: PMC7603257 DOI: 10.29252/rbmb.9.2.156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 02/28/2020] [Indexed: 10/31/2022]
Abstract
BACKGROUND Mycoplasma pneumoniae is one of the widespread causes of community-acquired pneumonia (CAP). Over recent years, the widespread use of macrolides has led to the emergence of macrolide-resistant M.pneumoniae (MRMP) resulted from mutations at specific positions of domain V of the 23S rRNA gene. METHODS We collected 100 samples of throat swabs from patients with respiratory infections. After extraction of DNA from bacterial cell cultured in PPLO broth media using Roche kit (Germany), the PCR was performed on specific samples of M. pneumoniae using specific primers for 23S rRNA gene.Afterwards, for positive samples, minimum inhibitory concentration (MIC) was determined using the broth microdilution with Clarithromycin. Finally, the PCR product was sequenced to detect mutations related to macrolide resistance in domain V of 23S rRNA . RESULTS According to the analysis of the sequenced PCR product of M. pneumoniae 23S rRNA gene using Clustalw2 online software, one of the samples were shown to have a mutation at A2431G and G2491A positions. The MIC measurement also revealed that all isolates were sensitive to Clarithromycin, and there was no macrolide resistance to Clarithromycin in all isolates. CONCLUSION Sequence analysis of the 23S rRNA gene in M. pneumoniae , revealed no macrolide resistance of M. pneumoniae to Clarithromycin. Thus, the use of these antibiotics should be restricted to prevent the development of macrolide-resistant M. pneumoniae in Iran.
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Affiliation(s)
| | - Iman Pouladi
- Department of Microbiology, Faculty of Medicine, LorestanUniversity of Medical Sciences, Khorramabad, Iran.
| | | | - Mohammad Niakan
- Department of Microbiology, Faculty of Medicine, LorestanUniversity of Medical Sciences, Khorramabad, Iran.
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Chen L, Chen J, Ramesh T, Seshadri VD, Zhu L. Zinc oxide nanoparticles from Corydalis yanhusuo attenuated the mycoplasmal pneumonia in mice through inhibiting the MAPKs signaling pathway. Microb Pathog 2020; 147:104270. [PMID: 32446872 DOI: 10.1016/j.micpath.2020.104270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The Mycoplasma pneumoniae (M.pneumoniae) was accounted to 3-10% of total pneumonia incidences. In recent decades, metallic nanoparticles were extensively examined as nano-antibiotics. OBJECTIVE In this investigation, we intended to inspect the therapeutic potential of Zinc oxide nanoparticles (ZnONPs) from (Corydalis yanhusuo) C. yanhusuo against the mycoplasma infected pneumonia in mice. METHODOLOGY The ZnONPs were formulated via green route technique and characterized by UV-vis spectroscopy, transmission electron microscopy, Fourier transform infrared technique, and atomic force microscopy. The antimicrobial activity of formulated ZnONPs was tested by well diffusion method. The total protein, interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-α) and transforming growth factor (TGF) status in the BALF of M. pneumonia infected animals were investigated via kit method. The expressions of ERK1/2, JNK1/2, and NF-κB were examined through the Western blotting. The Histopathological analysis of lung tissues of experimental animals was done. RESULTS The UV-vis spectroscopy and TEM examinations were proved the existence of CY-ZnONPs. The formulated CY-ZnONPs were displayed the potential antimicrobial activity. The supplementation of CY-ZnONPs were noticeably diminished the total protein and IL-6, IL-8, and TNF-α levels in the BALF of pneumonia mice. The ERK1/2, JNK1/2, and NF-κB expressions were appreciably diminished in the CY-ZnONPs supplemented mice. It also reduced the inflammatory cells penetration, and exhibited normal tissue arrangements in the lung tissues of pneumonia mice. CONCLUSION The findings of this investigation were proved that the synthesized CY-ZnONPs has the potential to ameliorate the M. pneumoniae infected pneumonia in investigational mice.
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Affiliation(s)
- Liang Chen
- Department of Infectious Disease, Beijing Jishuitan Hospital, 4 Th Medical College of Peking University, Beijing, 100096, China.
| | - Jun Chen
- Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, 210008, China
| | - Thiyagarajan Ramesh
- Department of Basic Medical Sciences, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Vidya Devanathadesikan Seshadri
- Department of Pharmacology and Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Limei Zhu
- Department of Chronic Disease and Infectious Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, 210009, China
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Zhao J, Li Y, Zhang W. The clinical significance of IL-6 s and IL-27 s in Bronchoalveolar lavage fluids from children with mycoplasma pneumoniae pneumonia. BMC Infect Dis 2020; 20:331. [PMID: 32393186 PMCID: PMC7216321 DOI: 10.1186/s12879-020-05017-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 04/06/2020] [Indexed: 12/19/2022] Open
Abstract
Background IL-6 was associated with the severity of mycoplasma pneumoniae pneumonia (MPP). But the relationship between IL-27 and MPP was unknown. Methods Ninety-eight patients with MPP < 14 years old were enrolled in this study and divided into groups by severity (mild cases and severe cases), infection types (MP single infection group and MP mixed infection group) and DNA loads (low MP DNA loads group and high MP DNA loads group), respectively. Fifteen children with foreign bodies in bronchus were also enrolled as control. IL-6 s and IL-27 s in bronchoalveolar lavage fluids (BALFs) from these children were measured by ELISA. Results There were significant differences in IL-6 s of BALFs from patients between mild cases and severe cases, MP single infection group and MP mixed infection group, and low MP DNA loads group and high MP DNA loads group, respectively (P < 0.05). Compared with IL-6 s of BALFs from control, IL-6 s in BALFs from the 6 patient groups were significantly higher (P < 0.05). IL-27 s in BALFs from MP mixed infection group were significantly lower than those from MP single infection group and control (P < 0.05) respectively. Conclusion IL-6 was firmly associated with MPP and had potential application in clinical practice while IL-27 was not related to MP infection.
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Affiliation(s)
- Jie Zhao
- Pediatrics, Zibo Central Hospital, Zibo, 255036, Shandong Province, China
| | - Yuyun Li
- Allergy Clinic, Zibo Central Hospital, Zibo, 255036, Shandong Province, China
| | - Wen Zhang
- Clinical Laboratory, Zibo Central Hospital, No. 54, Gongqingtuanxi Street, Zibo, 255036, Shandong Province, China.
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The Prevalence of Atypical Pneumonia Caused by Mycoplasma pneumoniae (P1 gene) in Patients with Respiratory Infections by Culture and Molecular PCR Methods in Tehran, Iran. Jundishapur J Microbiol 2020. [DOI: 10.5812/jjm.84174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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26
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The Mycoplasma pneumoniae HapE alters the cytokine profile and growth of human bronchial epithelial cells. Biosci Rep 2019; 39:BSR20182201. [PMID: 30573530 PMCID: PMC6340952 DOI: 10.1042/bsr20182201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/19/2018] [Accepted: 12/19/2018] [Indexed: 12/12/2022] Open
Abstract
Mycoplasma pneumoniae is one of the most common pathogenic causes of community-acquired pneumonia. Hydrogen sulfide, alanine, and pyruvate producing enzyme (HapE) is a recently discovered M. pneumoniae virulence factor that can produce H2S to promote erythrocyte lysis. However, other cytotoxic effects of HapE have not been explored. The present study examined the effects of this enzyme on normal human bronchial epithelial (NHBE) cells, in an attempt to identify additional mechanisms of M. pneumoniae pathogenesis. Recombinant HapE was purified for use in downstream assays. MTT and colony formation assays were conducted to determine the effects of HapE on cell viability and growth, while flow cytometry was used to examine changes in cell proliferation and cell cycle function. ELISA was performed to examine changes in the cytokine profile of HapE-treated cells. HapE treatment arrested NHBE cells in S phase and inhibited cell proliferation in a concentration-dependent manner. The anti-inflammatory factors interleukin (IL)-4 and IL-6 were significantly enhanced following HapE treatment. Increased secretion of pro-inflammatory factors was not observed. The effects of HapE on the respiratory epithelium may have an impact on the efficiency of host immune surveillance and pathogen elimination, and contribute to the pathogenesis of M. pneumoniae.
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Akashi Y, Hayashi D, Suzuki H, Shiigai M, Kanemoto K, Notake S, Ishiodori T, Ishikawa H, Imai H. Clinical features and seasonal variations in the prevalence of macrolide-resistant Mycoplasma pneumoniae. J Gen Fam Med 2018; 19:191-197. [PMID: 30464865 PMCID: PMC6238234 DOI: 10.1002/jgf2.201] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 06/15/2018] [Accepted: 07/31/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Mycoplasma pneumoniae is a common pathogen causing pneumonia; macrolide-resistant strains are rapidly spreading across Japan. However, the clinical features of macrolide-resistant M. pneumoniae pneumonia have not been well established. Here, we evaluated the clinical characteristics and seasonal variations in the prevalence of M. pneumoniae with macrolide-resistant mutations (MRM). METHODS The monthly prevalence of MRM in M. pneumoniae strains isolated from May 2016 to April 2017 was retrospectively analyzed, and the clinical characteristics of pneumonia cases with MRM were compared to those of cases without MRM. The M. pneumoniae isolates and point mutations at site 2063 or 2064 in domain V of 23S rRNA were evaluated by the GENECUBE system and GENECUBE Mycoplasma detection kit. RESULTS Mycoplasma pneumoniae infection was identified in 383 cases, including 221 cases of MRM (57.7%). The MRM prevalence was 86.3% (44/51) between May and July 2016, demonstrating an apparent decrease in September 2016, subsequently reaching 43.0% (34/79) in November 2016. Mycoplasma pneumoniae pneumonia was diagnosed in 275 cases, including 222 pediatric and 53 adult cases. Macrolide use preceding evaluation was found to be the only feature of MRM pneumonia cases both in children (odds ratio [OR] 3.86, 95% confidence interval [CI]:1.72-8.66) and in adults (OR 7.43, 95% CI: 1.67-33.1). CONCLUSIONS The determination rate of MRM varied widely throughout the year, and our study demonstrated the challenges in predicting M. pneumoniae with MRM based on clinical features at diagnosis. Therefore, continuous monitoring of the prevalence of MRM is warranted, which may help in selecting an effective treatment.
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Affiliation(s)
- Yusaku Akashi
- Division of Infectious DiseasesDepartment of MedicineTsukuba Medical Center HospitalTsukubaIbarakiJapan
| | - Daisuke Hayashi
- Department of PediatricsTsukuba Medical Center HospitalTsukubaIbarakiJapan
| | - Hiromichi Suzuki
- Division of Infectious DiseasesDepartment of MedicineTsukuba Medical Center HospitalTsukubaIbarakiJapan
| | - Masanari Shiigai
- Department of RadiologyTsukuba Medical Center HospitalTsukubaIbarakiJapan
| | - Koji Kanemoto
- Department of Respiratory MedicineTsukuba Medical Center HospitalTsukubaIbarakiJapan
| | - Shigeyuki Notake
- Department of Clinical LaboratoryTsukuba Medical Center HospitalTsukubaIbarakiJapan
| | - Takumi Ishiodori
- Division of Infectious DiseasesDepartment of MedicineTsukuba Medical Center HospitalTsukubaIbarakiJapan
| | - Hiroichi Ishikawa
- Department of Respiratory MedicineTsukuba Medical Center HospitalTsukubaIbarakiJapan
| | - Hironori Imai
- Department of PediatricsTsukuba Medical Center HospitalTsukubaIbarakiJapan
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Ameliorative Effects of Infantile Feire Kechuan Oral Solution on Mycoplasma Pneumoniae Pneumonia in Infant Mouse and Rat Models. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:8139040. [PMID: 30305831 PMCID: PMC6166364 DOI: 10.1155/2018/8139040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 08/08/2018] [Accepted: 08/16/2018] [Indexed: 11/17/2022]
Abstract
Mycoplasma pneumoniae (MP) infection is a major pathogen of community-acquired pneumonia (CAP) in children worldwide. Infantile Feire Kechuan Oral Solution (IFKOS) has been used for the treatment of MP pneumonia clinically in China for many years. The present study was designed to investigate the therapeutic effect of IFKOS on MP pneumonia and explore the potential mechanism of the actions. The infant BALB/c mouse and Wistar rat models of MP infection were successfully established to confirm the therapeutic effects of IFKOS, followed by assays for related cytokines and investigations of the IgM response involved. The results showed that IFKOS exhibited an inhibitory effect on pulmonary index (PI) and effectively reduced the degree of lesions in the lungs. The lethal rate of mice was significantly decreased while survival time of mice was dramatically increased by IFKOS treatment in comparison to infection control, respectively. IFKOS treatment (40, 20, and 10ml/kg) significantly decreased the level of MP-IgM in a dose-dependent manner, whereas IFKOS showed no obvious inhibitory effect on the increase of relative expression of MP-DNA. In addition, the elevated IL-2 and TNF-α levels were significantly reduced and the decreased IL-6 level was significantly enhanced by IFKOS treatment. Our study demonstrates that IFKOS has inhibitory effect on MP infection in infant mouse and rat models of MP pneumonia and protective effect from lethal MP challenge in infant murine model. These anti-MP effects might be related to suppression of the IgM response and a reversal the imbalance of Th1/Th2 cytokines induced by MP infection.
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Rhabdomyolysis: An Unusual Presentation of Mycoplasma pneumoniae Infection in an Adult-A Case Report and Literature Review. Case Rep Med 2018; 2018:6897975. [PMID: 30034476 PMCID: PMC6033244 DOI: 10.1155/2018/6897975] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 04/29/2018] [Indexed: 11/17/2022] Open
Abstract
Mycoplasma pneumoniae is a common cause of community-acquired pneumonia, and many extrapulmonary manifestations have been described, but rhabdomyolysis is infrequently reported in adults. Of the few cases that have been reported in adults, it was almost exclusively seen when pneumonia was present. We report a case of a 30-year-old male who came in with complaints of fever and myalgia for three days. Immunoglobulin M antibodies for Mycoplasma pneumoniae were positive and trending up, despite having no radiographic evidence of pneumonia on chest X-ray or CT scan. He was treated successfully with levofloxacin and intravenous hydration. Later, his condition was clinically and biochemically improved, and he was discharged. Our patient did not present with typical respiratory tract symptoms of a mycoplasma infection. In addition, there was an absence of pneumonia on imaging, suggesting that rhabdomyolysis secondary to mycoplasma might be underdiagnosed and go untreated in the setting of low clinical suspicion. Upon review of the literature, there is only one other case of mycoplasma infection where rhabdomyolysis occurred in the absence of pneumonia. However, the degree of rhabdomyolysis in our case was much more severe. Although rare, when faced with rhabdomyolysis, Mycoplasma pneumoniae should be kept as a differential diagnosis even in the absence of pneumonia on radiological imaging.
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Detection of Mycoplasma pneumoniae Among Children with Pneumonia Using Bacterial Culture, Polymerase Chain Reaction, and the Enzyme-linked Immunosorbent Assay Techniques in Ahvaz, Iran. Jundishapur J Microbiol 2018. [DOI: 10.5812/jjm.55554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Saraya T. Mycoplasma pneumoniae infection: Basics. J Gen Fam Med 2017; 18:118-125. [PMID: 29264006 PMCID: PMC5689399 DOI: 10.1002/jgf2.15] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 02/05/2016] [Indexed: 01/08/2023] Open
Abstract
Mycoplasma pneumoniae (Mp) is one of the leading causes of community‐acquired pneumonia and can cause a number of extrapulmonary manifestations in the absence of pneumonia. In this regard, primary care physicians should know how to suspect, diagnose, and manage patients with Mp infection. This review gives a general overview of the basic clinical aspects of Mp infection with special reference to pneumonia, which will help further understanding of the disease.
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Affiliation(s)
- Takeshi Saraya
- Department of Respiratory Medicine Kyorin University School of Medicine Tokyo Japan
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