1/97. Severe mycoplasma pneumoniae pneumonia.Four cases of severe mycoplasma pneumoniae infection are reported which were treated in a single hospital over the course of 4 years. The difficulties in the diagnosis of M. pneumoniae infections are eminently demonstrated by these cases. Because of the fact that it generally takes 2-o weeks to make this diagnosis, the physician must utilize clues of limited reliability. If gram stains and culture of sputum fail to demonstrate any bacterial pathogen and the patient has a chest X-ray compatible with this diagnosis as well as a white blood count less than 15,000/mm3, M. pneumoniae infection may be present. A good antimicrobial choice in such a situation is erythromycin.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
2/97. mycoplasma pneumoniae-associated bronchiolitis causing severe restrictive lung disease in adults: report of three cases and literature review.STUDY OBJECTIVES: To characterize adult mycoplasma pneumoniae-induced bronchiolitis requiring hospitalization. DESIGN: We encountered an adult patient with severe bronchiolitis in the absence of pneumonia due to M. pneumoniae. To determine the relative frequency of such a condition, we retrospectively reviewed the medical records of adults over a 4-year period with a hospital discharge diagnosis of "bronchiolitis" from a university hospital. SETTING: University Hospital of the University of colorado health Sciences Center, Denver, CO. Study subjects: From 1994 to 1998, 10 adult inpatients were identified with a diagnosis of bronchiolitis. There were two with respiratory bronchiolitis, one with panbronchiolitis, one patient with bronchiolitis obliterans organizing pneumonia (BOOP), and six with acute inflammatory bronchiolitis. Including the initial patient, three had a definitive clinical diagnosis of Mycoplasma-associated bronchiolitis. RESULTS: The three adult patients with bronchiolitis due to M. pneumoniae are unusual because they occurred in the absence of radiographic features of a lobar or patchy alveolar pneumonia. Hospital admission was occasioned by the severity of symptoms and gas exchange abnormalities. One patient had bronchiolitis as well as organizing pneumonia (BOOP) that responded favorably to corticosteroid treatment. The other two had high-resolution CT findings diagnostic of an acute inflammatory bronchiolitis. One of the patients with inflammatory bronchiolitis had an unusual pattern of marked ventilation and perfusion defects localized predominantly to the left lung. All three had restrictive ventilatory impairment on physiologic testing. CONCLUSIONS: In adults, Mycoplasma-associated bronchiolitis without pneumonia is rarely reported, but in hospitalized patients, it may be more common than expected and may be associated with severe physiologic disturbances.- - - - - - - - - - ranking = 1.0909090909091keywords = pneumonia (Clic here for more details about this article) |
3/97. infection of a traumatic pelvic hematoma with mycoplasma hominis.fever developed in a previously healthy young man who had sustained extensive pelvic trauma. mycoplasma hominis was isolated in pure culture from six of seven specimens taken from a retroperitoneal hematoma over a one-week period, and mycoplasmacidal antibodies were present in high titer in the convalescent-phase serum. The fever abated after thorough surgical drainage of the infected hematoma.- - - - - - - - - - ranking = 1075.0866023081keywords = mycoplasma (Clic here for more details about this article) |
4/97. Acute encephalopathy and intractable seizures in a 10-year-old boy.We report a 10-year-old child with Robinow's syndrome who had a 2-week history of headaches and dizziness. On the day of admission, he developed a focal onset seizure with rapid secondary generalization. The seizures were intractable despite adequate doses of benzodiazepine, phenytoin, and phenobarbital, requiring a pentobarbital drip. Continuous electroencephalogram (EEG) monitoring showed persistence of the epileptiform discharges for 13 days. cerebrospinal fluid and brain biopsy studies were unrevealing. Mycoplasma pneumonia titers showed elevation of both immunoglobulins G and M that doubled during the tenth hospital day. High-dose methylprednisolone was begun, and within 12 hours of initiation the patient sat up and began to follow commands appropriately. The overall EEG background markedly improved. central nervous system mycoplasma pneumoniae infection should be suspected in patients with an encephalopathy of unclear etiology.- - - - - - - - - - ranking = 0.18181818181818keywords = pneumonia (Clic here for more details about this article) |
5/97. mycoplasma pneumoniae infections and exanthems.A review of the medical literature and two case reports of M. pneumoniae infections with exanthems are presented. Erythematous maculopapular and vesicular exanthems were most common. The duration of rash was more than seven days in the majority of instances, and most patients had associated pneumonia. A striking difference in prevalence and clinical symptomatology by sex was noted; 16 of 20 patients analyzed were males, and they frequently dad severe mucocutaneous syndromes. In contrast, severe conjunctivitis, generalized ulcerative stomatitis, and vesicular or bullous exanthems were not seen in females. Clinicians should suspect infection with M. pneumoniae in patients with exanthem and pneumonia, although other etiologic possibilities should also be considered.- - - - - - - - - - ranking = 0.72727272727273keywords = pneumonia (Clic here for more details about this article) |
6/97. PCR in meningoencephalitis diagnosis.polymerase chain reaction (PCR) detection of a stretch of nucleic acid sequence of microbial origin from a clinical sample is not always diagnostic of disease unless the identified agent is a strict pathogen or its growth is documented. We describe here a case of acute meningoencephalitis in a 21-y-old man, in whom no pathogen was isolated by traditional bacterial or viral culture. Standard dna PCR performed on the cerebrospinal fluid (CSF) identified the presence of 3 infectious agents: HHV-6, HHV-7 and mycoplasma pneumoniae. Additional PCRs performed on CSF fractions along with gene transcript analysis proved the bystander role of the 2 herpesviruses and indicated M. pneumoniae as the relevant replicating agent, most likely playing to be a pathogenic role. Until this useful analysis becomes routine, clinicians should deal carefully with dna PCR results, especially when assessing the aetiological role of agents, such as herpesviruses, which are known to undergo latency.- - - - - - - - - - ranking = 0.18181818181818keywords = pneumonia (Clic here for more details about this article) |
7/97. adult Still's disease associated with mycoplasma pneumoniae infection.adult Still's disease (ASD) is a systemic inflammatory disorder of unknown origin. Several reports have suggested a triggering infection in ASD. We describe a case of ASD associated with acute mycoplasma pneumoniae infection. The close temporal relationship between ASD and acute infection strongly suggests that M. pneumoniae triggered ASD. We suggest that M. pneumoniae should be added to the list of infectious agents that may play a role in its etiology.- - - - - - - - - - ranking = 0.63636363636364keywords = pneumonia (Clic here for more details about this article) |
8/97. mycoplasma pneumoniae non-pulmonary infection presenting with pharyngitis, polyarthritis and localized exanthem.We report a case of pharyngitis, polyarthritis and localized exanthem in acute mycoplasma pneumoniae infection not involving the lower respiratory tract. diagnosis was made by means of a particle agglutination test and IgM/IgG indirect immunofluorescence assay. This case describes a clinical complex never reported before and suggests the need for a high index of suspicion in cases of atypical presentation of M. pneumoniae infection.- - - - - - - - - - ranking = 0.54545454545455keywords = pneumonia (Clic here for more details about this article) |
9/97. Persistent cerebellar symptoms after infection with mycoplasma pneumoniae.mycoplasma pneumoniae infection in a 47-year-old man is reported. Symptoms of upper respiratory tract infection were followed by pneumonia and meningoencephalitis. In contrast to published cases with neurological manifestations of infection with M. pneumoniae, the patient was disabled by persistent cerebellar symptoms with generalized ataxia and atactic dysarthria. Some possible pathogenic mechanisms of the neurological manifestations of infection with M. pneumoniae are considered.- - - - - - - - - - ranking = 0.72727272727273keywords = pneumonia (Clic here for more details about this article) |
10/97. Treatment of resistant mycoplasma infection in immunocompromised patients with a new pleuromutilin antibiotic.Patients with primary antibody deficiency (PAD) are prone to mycoplasma infection with unusual strains which may be resistant to conventional antibiotics. Mycoplasmas were isolated from the joint fluid (ureaplasma urealyticum) of two PAD patients with arthritis and from the cerebral spinal fluid (Mycoplasma maculosum) in one with meningitis, the latter probably originating from the patient's dog. Combinations of doxycycline and quinolones or macrolides failed to clear the infections, but after demonstrating in-vitro sensitivity to the pleuromutilin, Econor, for two of the isolates, all three patients responded to oral treatment with Econor. The infection was completely eradicated in two patients, with the emergence of a resistant strain in the third.Mycoplasma infection should be considered in PAD patients with unexplained sepsis. Pleuromutilins such as Econor are powerful new anti-mycoplasmal agents which provide an additional therapeutic option when patients fail to respond to conventional antibiotics.- - - - - - - - - - ranking = 6450.5196138487keywords = mycoplasma (Clic here for more details about this article) |
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