BMC Infectious Diseases 2006, 6:18doi:10.1186/1471-2334-6-18
Case report
1 Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
2 Department of Cardiothoracic surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
3 Department of Clinical Microbiology and Infectious diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
4 Department of Molecular & Cell Biology, 510 Barker Hall #3202, University of California, Berkeley, CA 94720-3202, USA
The electronic version of this article is the complete one and can be found online at:
http://www.biomedcentral.com/1471-2334/6/18
Published: 1 February 2006
© 2006 Shuvy et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Mycoplasma pneumoniae is responsible for more than 20% of community acquired pneumonia cases, and capable of causing upper respiratory illness as well. Complications of M.pneumoniae infections include CNS involvement but other as pericarditis were also reported. The lack of feasible culture methods and under appreciation of the pathogens ability to cause invasive disease leads to reduced number of diagnosed M.pneumoniae related complications. In contrast to many other respiratory pathogens causing pneumonia, M. pneumoniae related severe pleural complications were almost never reported.
We report a previously healthy 57 years old woman presented with indolent massive right pleural effusion, leukocytosis and elevated ESR. Extensive microbiological evaluation didn't reveal any pathogen in the pus even before antibiotic treatment was started. Surprisingly, M.pneumoniae DNA was detected in the pus from the empyema using PCR designed to detect M.pneumoniae. A serological assay (Serodia-Myco II) using convalescent serum was indeterminate with a titer of 1:80. The patient responded well to a treatment that included right thoracotomy with pleural decortication and a combination of antibiotics and anti-inflammatory medications.
M.pneumoniae related empyema was never reported before in adult patients and was reported in only a few pediatric patients. In our patient there was no evidence to any common pathogens even before initiating antibiotic treatment. The only pathogen detected was M.pneumoniae. In this patient, serology was not helpful in establishing the diagnosis of M.pneumoniae related diseases, as was suggested before for older patients. We suggest that M.pneumoniae related empyema is probably under-diagnosed complication due to insensitivity of serology in older patients and under use of other diagnosis methods.
Full Text article at : http://www.biomedcentral.com/1471-2334/6/18
Also available as PDF document
Disclaimer:
Information on this site is provided for educational purposes only and
is not meant to substitute the advice provided by your own physician or other
medical professionals.
Consult your own physician regarding the applicability of any information
listed on this website with respect to your symptoms or medical condition
