ABSTRACT
Understanding the proportion of SARS-CoV-2 patients with Mycoplasmapneumoniae coinfection is crucial for treating patients suffering from coronavirus disease (COVID-19), help to ensure responsible use of antibiotics and minimize the negative consequences of overuse. In addition, this knowledge could have an impact on empirical antibiotic management guidelines for patients with COVID-19. This systematic review aimed to identify the prevalence of M. pneumoniae in patients with coronavirus disease 2019 (COVID-19). A bibliographic search of studies published in Spanish or English was conducted using the PubMed search engine. Fourteen articles from different continents (America, Asia and Europe) were included, involving a total of 5855 patients in these studies. The mean age of COVID-19 patients with M. pneumoniae was 48 years old (range 1-107), most of whom were male. The detection of laboratory-confirmed M. pneumoniae infection varied between 0 and 33.3%. Most of patients referred fever, cough, and dyspnea, and received empirical antibiotic treatment. Bacterial coinfection was not associated with increased ICU admission and mortality. The prevalence of coinfection showed extremely dissimilar figures according to the population studied and diagnostic criteria. However, it is important to develop Latin American studies, given the heterogeneity observed in the studies conducted in different countries. Standardized definitions should be developed in order to be able to assess the impact of coinfections in patients with a diagnosis of COVID-19.
Subject(s)
COVID-19 , Coinfection , Pneumonia, Mycoplasma , Humans , COVID-19/complications , COVID-19/epidemiology , Coinfection/epidemiology , Pneumonia, Mycoplasma/epidemiology , Pneumonia, Mycoplasma/complications , Pneumonia, Mycoplasma/drug therapy , Prevalence , Mycoplasma pneumoniae , Child , Aged , Adult , Aged, 80 and over , Child, Preschool , Young Adult , Middle Aged , Adolescent , Male , Anti-Bacterial Agents/therapeutic use , Infant , FemaleABSTRACT
OBJECTIVE: This study aimed to investigate the clinical significance of serum microRNA-146a and pro-inflammatory factors in children with Mycoplasma pneumoniae pneumonia after azithromycin treatment. microRNA-146a is known to regulate inflammatory responses, and excessive inflammation is a primary characteristic of MPP. METHODS: Children with MPP received conventional symptomatic therapy along with intravenous administration of azithromycin for one week. Serum levels of microRNA-146a and pro-inflammatory factors were measured using RT-qPCR and ELISA kits, respectively. The correlation between microRNA-146a and pro-inflammatory factors was analyzed by the Pearson method. Pulmonary function indexes were assessed using a pulmonary function analyzer, and their correlation with microRNA-146a and pro-inflammatory factors after treatment was evaluated. Children with MPP were divided into effective and ineffective treatment groups, and the clinical significance of microRNA-146a and pro-inflammatory factors was evaluated using receiver operating characteristic curves and logistic multivariate regression analysis. RESULTS: Serum microRNA-146a was downregulated in children with MPP but upregulated after azithromycin treatment, contrasting with the trend observed for pro-inflammatory factors. MicroRNA-146a showed a negative correlation with pro-inflammatory cytokines. Pulmonary function parameters were initially reduced in children with MPP, but increased after treatment, showing positive/inverse associations with microRNA-146a and pro-inflammatory factors. Higher microRNA-146a and lower pro-inflammatory factors predicted better efficacy of azithromycin treatment. MicroRNA-146a, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), and forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) were identified as independent factors influencing treatment efficacy. CONCLUSION: Azithromycin treatment in children with MPP upregulates microRNA-146a, downregulates pro-inflammatory factors, and effectively improves pulmonary function.
Subject(s)
MicroRNAs , Pneumonia, Mycoplasma , Child , Humans , Azithromycin/therapeutic use , Mycoplasma pneumoniae , Clinical Relevance , Pneumonia, Mycoplasma/drug therapy , MicroRNAs/therapeutic useABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the efficacy of the use of four concomitant Chinese medicines with azithromycin in the treatment of mycoplasma pneumonia in children (MPC) by using network meta-analysis (NMA) and ranking them according to their performances. METHODS: There were a total of 130 randomly controlled trials of four different concomitant Chinese medicines with azithromycin for the treatment of MPC in many databases, and an NMA was conducted in them by using Stata (version 13.0) software to evaluate the odds ratio (OR) and sequence of the different combinations. The included studies were divided into two groups: control group (azithromycin alone) and observation group (one of four azithromycin combinations). RESULTS: A total of 13119 cases were included in this study, and the results showed that the pooled OR and 95% confidence interval (CI) of MPC improvement compared with azithromycin alone were 4.76 (3.18-7.14) for azithromycin and Reduning, 5.66 (4.50-7.12) for azithromycin and Tanreqing, 4.84 (3.35-7.01) for azithromycin and Xiyanping, and 4.58 (3.59-5.83) for azithromycin and Yanhuning, respectively. This study shows the significant efficacy of Chinese concomitant drug. The combination of azithromycin with Tanreqing is the best candidate of concomitant drug in terms of clinical efficacy. Its surface under the cumulative ranking (SUCRA) score was 85.5, while the SUCRA score for the azithromycin and Yanhuning combination was the worst, which is 48.4. CONCLUSIONS: The combination of azithromycin with Tanreqing is the most promising group among four combinations for the treatment of MPC.
Subject(s)
Mycoplasma , Pneumonia, Mycoplasma , Randomized Controlled Trials as Topic , Azithromycin/therapeutic use , Child , China , Humans , Network Meta-Analysis , Pneumonia, Mycoplasma/drug therapyABSTRACT
One of the leading causes of pneumonia in children between 5 to 15 years is Mycoplasma pneumoniae, a bacterium that causes atypical clinical manifestations such as myositis and encephalitis. We report a 5-year-old girl who presented functional limitations of the lower extremities preceded by an upper respiratory infection. Later on, she developed pneumonia and encephalitis. Antibiotics and antivirals were administered due to the clinical deterioration of the patient. IgM serology for Mycoplasma pneumoniae was positive, while the other viral studies were negative. The clinical course was favorable with a progressive decrease in respiratory distress, sensorial disorder, and improvement in the functional limitations of the lower limbs after 15 days of treatment.
Una de las principales causas de neumonía en niños entre 5 y 15 años es el Mycoplasma pneumoniae, una bacteria que causa manifestaciones clínicas atípicas como la miositis y encefalitis. Reportamos un caso de una niña de cinco años que presentó limitación funcional en extremidades inferiores precedida por una infección respiratoria superior. Posteriormente, se complicó con neumonía y encefalitis. Se administraron antibióticos y antivirales debido al deterioro clínico del paciente. La serología de inmunoglobulinas para Mycoplasma pneumoniae fue positiva; mientras que los demás estudios virales fueron negativos. El curso clínico fue favorable con disminución progresiva de la dificultad respiratoria, trastorno del sensorio y mejoría en la limitación funcional en las extremidades inferiores a los 15 días de tratamiento.
Subject(s)
Encephalitis/diagnosis , Mycoplasma pneumoniae/isolation & purification , Myositis/diagnosis , Pneumonia, Mycoplasma/diagnosis , Acute Disease , Anti-Bacterial Agents/administration & dosage , Child, Preschool , Encephalitis/drug therapy , Encephalitis/microbiology , Female , Humans , Myositis/drug therapy , Myositis/microbiology , Pneumonia, Mycoplasma/drug therapy , Pneumonia, Mycoplasma/microbiologyABSTRACT
Una de las principales causas de neumonía en niños entre 5 y 15 años es el Mycoplasma pneumoniae, una bacteria que causa manifestaciones clínicas atípicas como la miositis y encefalitis. Reportamos un caso de una niña de cinco años que presentó limitación funcional en extremidades inferiores precedida por una infección respiratoria superior. Posteriormente, se complicó con neumonía y encefalitis. Se administraron antibióticos y antivirales debido al deterioro clínico del paciente. La serología de inmunoglobulinas para Mycoplasma pneumoniae fue positiva; mientras que los demás estudios virales fueron negativos. El curso clínico fue favorable con disminución progresiva de la dificultad respiratoria, trastorno del sensorio y mejoría en la limitación funcional en las extremidades inferiores a los 15 días de tratamiento.
One of the leading causes of pneumonia in children between 5 to 15 years is Mycoplasma pneumoniae, a bacterium that causes atypical clinical manifestations such as myositis and encephalitis. We report a 5-year-old girl who presented functional limitations of the lower extremities preceded by an upper respiratory infection. Later on, she developed pneumonia and encephalitis. Antibiotics and antivirals were administered due to the clinical deterioration of the patient. IgM serology for Mycoplasma pneumoniae was positive, while the other viral studies were negative. The clinical course was favorable with a progressive decrease in respiratory distress, sensorial disorder, and improvement in the functional limitations of the lower limbs after 15 days of treatment.
Subject(s)
Humans , Female , Child, Preschool , Pneumonia, Mycoplasma/diagnosis , Encephalitis/diagnosis , Mycoplasma pneumoniae/isolation & purification , Myositis/diagnosis , Pneumonia, Mycoplasma/microbiology , Pneumonia, Mycoplasma/drug therapy , Acute Disease , Encephalitis/microbiology , Encephalitis/drug therapy , Anti-Bacterial Agents/administration & dosage , Myositis/microbiology , Myositis/drug therapyABSTRACT
INTRODUCTION: Community-acquired pneumonia (CAP) is a global disease responsible for a large number of deaths, with significant economic impact. As diagnostic tools have increased in sensitivity, understanding of the etiology of CAP has begun to change. Mycoplasma pneumoniae is one of the major pathogens causing CAP. Macrolides and related antibiotics are first-line treatments for M. pneumoniae. Macrolide resistance has been spreading for 15 years and now occurs in worldwide. We undertook the first study on macrolide resistance of M. pneumoniae in Yantai. This may be helpful to determine the appropriate therapy for CAP in this population. OBJECTIVE: To investigate the rate and mechanism of macrolide resistance in Yantai. METHODS: Pharyngeal swab samples were collected from adult CAP patients. Samples were assayed by polymerase chain reaction (PCR) and cultivated to test for M. pneumoniae. Nested PCR was used to specifically amplify M. pneumoniae 23S rRNA gene fragments containing mutations, and amplicons were analyzed by CE-SSCP for macrolide resistance mutations. Results were confirmed by sequencing. Twenty-seven strains of M. pneumoniae were isolated and the activities of nine antibiotics against M. pneumoniae were tested in vitro. RESULTS: Out of 128 samples tested, 27 were positive for M. pneumoniae. Mycoplasma 100% macrolides resistance to Mycoplasma pneumoniae. The mechanism of macrolides resistance was A2063G point mutation in the sequence directly binding to macrolides in the 23S rRNA V domain in vitro. The mean pyretolytic time for the fluoroquinolone group was 4.7 ±2.9 d, which was significantly shorter than 8.2 ±4.1 d for the azithromycin group. CONCLUSIONS: Macrolides are not the first-line treatment for M. pneumoniae respiratory tract infections in Yantai.
INTRODUCCIÓN: Neumonía adquirida por en la comunidad (NAC) es una enfermedad responsable por un gran número de muertes y un impacto económico importante. Debido a que el diagnostico incrementó la sensibilidad, se cambió la etiología de la NAC. Adicionalmente, Mycoplasma pneumoniae es uno de los patógenos que causan la NAC. Los macrólidos y antibióticos relacionados son la primera línea de tratamiento para M. pneumoniae. La resistencia a macrólidos se aumentó en los últimos 15 años y ahora se encuentra distribuido en todo el mundo. Nosotros realizamos el primer estudio de resitencia a M. pneumoniae a los macrólidos en Yantai. Esto podría ser útil para determinar una terapia apropiada para NAC en esta población. OBJETIVO: Investigar la tasa y el mecanismo para la resitencia a los macrólidos en Yantai. MÉTODOS: Se colectaron muestras faringeas usando un hisopo. Las muestras se analizaron mediante la reacción en cadena de la polimerasa (PCR) y por cultivo para M. pneumoniae. Se uso una PCR anidad para amplificar fragmentos del gen 23S rRNA especifico con las mutaciones para M. pneumoniae. Se analizaron amplicomes por CE-SSCP para determinar la resitencia a los macrólidos. Estos resultados se confirmaron por secuenciación. Se aislaron 27 cepas de M. pneumoniae y se probaron nueve antibióticos in vitro. RESULTADOS: De 128 muestras, 27 fueron positivas para M. pneumoniae. Se determinó una resistencia a macrólidos por Mycoplasma del 100%. Los mecanismos de esta resitencia fue una mutacion punctual A2063G en la secuencia que se une directamente a los macrólidos en el dominio 23S rRNA V in vitro. El tiempo piotolítico medio para el grupo de fluoroquinolonas fue 4.7 ±2.9 d, que fue significativamente más corto que para el grupo de azitromicina: 8.2 ±4.1 d. CONCLUSIONES: Los macrólidos no son la primera linea de tratamiento para las infecciones del tracto respiratorio contra M. pneumoniae respiratory tract infections en Yantai.
Subject(s)
Anti-Bacterial Agents/pharmacology , Community-Acquired Infections/epidemiology , Mycoplasma pneumoniae/isolation & purification , Pneumonia, Mycoplasma/epidemiology , Adolescent , Adult , Aged , China/epidemiology , Community-Acquired Infections/drug therapy , Community-Acquired Infections/microbiology , Drug Resistance, Bacterial/genetics , Female , Humans , Macrolides/pharmacology , Male , Middle Aged , Pneumonia, Mycoplasma/drug therapy , Pneumonia, Mycoplasma/microbiology , Point Mutation , Polymerase Chain Reaction , Young AdultABSTRACT
Abstract Introduction: Community-acquired pneumonia (CAP) is a global disease responsible for a large number of deaths, with significant economic impact. As diagnostic tools have increased in sensitivity, understanding of the etiology of CAP has begun to change. Mycoplasma pneumoniae is one of the major pathogens causing CAP. Macrolides and related antibiotics are first-line treatments for M. pneumoniae. Macrolide resistance has been spreading for 15 years and now occurs in worldwide. We undertook the first study on macrolide resistance of M. pneumoniae in Yantai. This may be helpful to determine the appropriate therapy for CAP in this population. Objective: To investigate the rate and mechanism of macrolide resistance in Yantai. Methods: Pharyngeal swab samples were collected from adult CAP patients. Samples were assayed by polymerase chain reaction (PCR) and cultivated to test for M. pneumoniae. Nested PCR was used to specifically amplify M. pneumoniae 23S rRNA gene fragments containing mutations, and amplicons were analyzed by CE-SSCP for macrolide resistance mutations. Results were confirmed by sequencing. Twenty-seven strains of M. pneumoniae were isolated and the activities of nine antibiotics against M. pneumoniae were tested in vitro. Results: Out of 128 samples tested, 27 were positive for M. pneumoniae. Mycoplasma 100% macrolides resistance to Mycoplasma pneumoniae. The mechanism of macrolides resistance was A2063G point mutation in the sequence directly binding to macrolides in the 23S rRNA V domain in vitro. The mean pyretolytic time for the fluoroquinolone group was 4.7 ±2.9 d, which was significantly shorter than 8.2 ±4.1 d for the azithromycin group. Conclusions: Macrolides are not the first-line treatment for M. pneumoniae respiratory tract infections in Yantai.
Resumen Introducción: Neumonía adquirida por en la comunidad (NAC) es una enfermedad responsable por un gran número de muertes y un impacto económico importante. Debido a que el diagnostico incrementó la sensibilidad, se cambió la etiología de la NAC. Adicionalmente, Mycoplasma pneumoniae es uno de los patógenos que causan la NAC. Los macrólidos y antibióticos relacionados son la primera línea de tratamiento para M. pneumoniae. La resistencia a macrólidos se aumentó en los últimos 15 años y ahora se encuentra distribuido en todo el mundo. Nosotros realizamos el primer estudio de resitencia a M. pneumoniae a los macrólidos en Yantai. Esto podría ser útil para determinar una terapia apropiada para NAC en esta población. Objetivo: Investigar la tasa y el mecanismo para la resitencia a los macrólidos en Yantai. Métodos: Se colectaron muestras faringeas usando un hisopo. Las muestras se analizaron mediante la reacción en cadena de la polimerasa (PCR) y por cultivo para M. pneumoniae. Se uso una PCR anidad para amplificar fragmentos del gen 23S rRNA especifico con las mutaciones para M. pneumoniae. Se analizaron amplicomes por CE-SSCP para determinar la resitencia a los macrólidos. Estos resultados se confirmaron por secuenciación. Se aislaron 27 cepas de M. pneumoniae y se probaron nueve antibióticos in vitro. Resultados: De 128 muestras, 27 fueron positivas para M. pneumoniae. Se determinó una resistencia a macrólidos por Mycoplasma del 100%. Los mecanismos de esta resitencia fue una mutacion punctual A2063G en la secuencia que se une directamente a los macrólidos en el dominio 23S rRNA V in vitro. El tiempo piotolítico medio para el grupo de fluoroquinolonas fue 4.7 ±2.9 d, que fue significativamente más corto que para el grupo de azitromicina: 8.2 ±4.1 d. Conclusiones: Los macrólidos no son la primera linea de tratamiento para las infecciones del tracto respiratorio contra M. pneumoniae respiratory tract infections en Yantai.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Pneumonia, Mycoplasma/epidemiology , Community-Acquired Infections/epidemiology , Anti-Bacterial Agents/pharmacology , Mycoplasma pneumoniae/isolation & purification , Pneumonia, Mycoplasma/microbiology , Pneumonia, Mycoplasma/drug therapy , China/epidemiology , Polymerase Chain Reaction , Point Mutation , Community-Acquired Infections/microbiology , Community-Acquired Infections/drug therapy , Macrolides/pharmacology , Drug Resistance, Bacterial/geneticsABSTRACT
OBJECTIVES: The aim of this study was to describe the genotypes and the main characteristics of community-acquired pneumonia (CAP) caused by Mycoplasma pneumoniae in hospitalized children in Medellín and neighboring municipalities during the period 2011-2012. METHODS: The M. pneumoniae genotype was determined by PCR and sequencing of the p1 and 23S rRNA genes from induced sputum samples and nasopharyngeal swabs (NPS). Samples were obtained from children with CAP who were hospitalized in 13 healthcare centers. In addition, a spatio-temporal analysis was performed to identify the potential risk areas and clustering of the cases over time. RESULTS: A variant of type 2 was the dominant genotype in the induced sputum (96.1%) and NPS (89.3%) samples; the type 1 variant was identified in 3.9% and 10.7% of these samples, respectively. No strains with mutations in the 23S rRNA gene associated with macrolide resistance were found. The cases in Medellín were mainly concentrated in the northeastern areas and western districts. However, no temporal relationship was found among these cases. CONCLUSIONS: A variant of type 2 of M. pneumoniae prevailed among children with CAP during the study period. No strains with mutations associated with macrolide resistance were found.
Subject(s)
Community-Acquired Infections/microbiology , Macrolides/pharmacology , Mycoplasma pneumoniae/genetics , Pneumonia, Mycoplasma/microbiology , Adolescent , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Colombia , Community-Acquired Infections/drug therapy , Drug Resistance, Bacterial/genetics , Female , Genotype , Humans , Male , Molecular Typing , Mutation , Mycoplasma pneumoniae/classification , Pneumonia, Mycoplasma/drug therapy , Polymerase Chain Reaction , RNA, Ribosomal, 23S/genetics , Spatio-Temporal AnalysisSubject(s)
Mycoplasma pneumoniae , Pneumonia, Mycoplasma/drug therapy , Pneumonia, Mycoplasma/epidemiology , Respiratory Tract Infections/drug therapy , Adolescent , Anti-Bacterial Agents/therapeutic use , Child , Cross Infection , History, 20th Century , Hospitals, Pediatric , Humans , Pediatrics/history , Pneumonia, Mycoplasma/microbiology , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/microbiologyABSTRACT
BACKGROUND: The aim of this study was to clarify retrospectively the characteristics of children hospitalized for respiratory tract infection caused by macrolide-resistant Mycoplasma pneumoniae (M. pneumoniae). METHODS: Children who were hospitalized for respiratory tract infection due to M. pneumoniae were enrolled in this study. The diagnosis of M. pneumoniae infection was made on the grounds of polymerase chain reaction results. RESULTS: Thirty-three children were hospitalized due to lower respiratory tract infection with M. pneumoniae. Of the 33 children, 31 (median age five years) were identified as being infected with macrolide-resistant M. pneumoniae (A2063G:30, A2064G:1) by sequence analysis. Of the 31 children infected with macrolide-resistant M. pneumoniae, 21 (68%) had received 14- or 15-membered macrolide antibiotics and four (13%) had received minocycline before hospitalization. During hospitalization, minocycline was administered to 16 (52%) of the 31 children infected with macrolide-resistant M. pneumoniae. Of the 20 children infected with macrolide-resistant M. pneumoniae under eight years of age, six (30%) were treated with minocycline during hospitalization. The difference in total febrile days between children receiving minocycline treatment before hospitalization and children not receiving minocycline treatment was three days. CONCLUSIONS: The majority of hospitalized children with respiratory tract infection due to macrolide-resistant M. pneumoniae infection was of preschool age and had received 14- or 15-membered macrolide antibiotics before hospitalization. Because macrolide-resistant M. pneumoniae is widespread in Japan, the administration of minocycline as a second-line antibiotic in children under eight years of age cannot be withheld when clinical symptoms do not improve with macrolide antibiotics. .
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Anti-Bacterial Agents/therapeutic use , Drug Resistance, Bacterial , Macrolides , Mycoplasma pneumoniae/genetics , Pneumonia, Mycoplasma/drug therapy , Hospitalization , Polymerase Chain Reaction , Pneumonia, Mycoplasma/diagnosis , Retrospective StudiesABSTRACT
BACKGROUND: The aim of this study was to clarify retrospectively the characteristics of children hospitalized for respiratory tract infection caused by macrolide-resistant Mycoplasma pneumoniae (M. pneumoniae). METHODS: Children who were hospitalized for respiratory tract infection due to M. pneumoniae were enrolled in this study. The diagnosis of M. pneumoniae infection was made on the grounds of polymerase chain reaction results. RESULTS: Thirty-three children were hospitalized due to lower respiratory tract infection with M. pneumoniae. Of the 33 children, 31 (median age five years) were identified as being infected with macrolide-resistant M. pneumoniae (A2063G:30, A2064G:1) by sequence analysis. Of the 31 children infected with macrolide-resistant M. pneumoniae, 21 (68%) had received 14- or 15-membered macrolide antibiotics and four (13%) had received minocycline before hospitalization. During hospitalization, minocycline was administered to 16 (52%) of the 31 children infected with macrolide-resistant M. pneumoniae. Of the 20 children infected with macrolide-resistant M. pneumoniae under eight years of age, six (30%) were treated with minocycline during hospitalization. The difference in total febrile days between children receiving minocycline treatment before hospitalization and children not receiving minocycline treatment was three days. CONCLUSIONS: The majority of hospitalized children with respiratory tract infection due to macrolide-resistant M. pneumoniae infection was of preschool age and had received 14- or 15-membered macrolide antibiotics before hospitalization. Because macrolide-resistant M. pneumoniae is widespread in Japan, the administration of minocycline as a second-line antibiotic in children under eight years of age cannot be withheld when clinical symptoms do not improve with macrolide antibiotics.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Drug Resistance, Bacterial , Macrolides , Mycoplasma pneumoniae/genetics , Pneumonia, Mycoplasma/drug therapy , Adolescent , Child , Child, Preschool , Female , Hospitalization , Humans , Infant , Male , Pneumonia, Mycoplasma/diagnosis , Polymerase Chain Reaction , Retrospective StudiesABSTRACT
Atypical pneumonias are a significant percentage of causal agents of pneumonia in children. Dominate over 5years of age, although in the last three years there is an increase in cases in children three years of age, especially secondary to Mycoplasma. In this review, we will refer to Mycoplasma pneumoniae, as the atypical germ most common and important in the epidemiology of children with pulmonary involvement. Mycoplasma pneumonia, can explain 20-25 percent of pneumonia in children, especially in preschool and school age.
Las neumonías atípicas constituyen un porcentaje importante de agentes causales de neumonía en niños. Predominan en mayores de 5 años de edad, aunque en los últimos años, existe un incremento de casos en niños de 3años de edad, sobre todo secundario al Mycoplasma. En esta revisión, nos referiremos al Mycoplasma pneumoniae, como el germen de los atípicos más frecuente e importante en la epidemiología del niño con afectación pulmonar. Las neumonías por mycoplasma, pueden explicar del 20 al 25 por ciento de las neumonías en niños, sobre todo en edades preescolares y escolares.
Subject(s)
Humans , Child , Pneumonia, Mycoplasma/diagnosis , Pneumonia, Mycoplasma/drug therapy , Anti-Bacterial Agents/therapeutic use , Clinical Laboratory Techniques , Pneumonia, Mycoplasma/complications , Pneumonia, Mycoplasma/transmission , Radiography, ThoracicABSTRACT
Human metapneumovirus is a newly discovered pathogen associated with respiratory disease and occurring mainly in children. It produces an acute viral respiratory disease picture that varies from mild disease to severe, and which can require strict surveillance in intensive care units. Currently, reverse transcriptase polymerase chain reaction and cell culture are the most common methods for its diagnosis. The first six cases of human metapneumovirus in Colombia are presented from Medellín.
Subject(s)
Metapneumovirus/isolation & purification , Paramyxoviridae Infections/virology , Pneumonia, Viral/virology , Adrenergic beta-2 Receptor Agonists/therapeutic use , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Clarithromycin/therapeutic use , Colombia/epidemiology , Female , Fever/etiology , Humans , Hypoxia/etiology , Immunologic Tests , Infant , Male , Paramyxoviridae Infections/complications , Paramyxoviridae Infections/diagnosis , Paramyxoviridae Infections/diagnostic imaging , Paramyxoviridae Infections/epidemiology , Pneumonia, Mycoplasma/complications , Pneumonia, Mycoplasma/drug therapy , Pneumonia, Viral/complications , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/epidemiology , Radiography , Reverse Transcriptase Polymerase Chain Reaction , Superinfection , Virus CultivationABSTRACT
El metaneumovirus humano es un nuevo patógeno asociado a infecciones respiratorias, principalmente en niños, que produce cuadros clínicos que van desde leves hasta graves, los cuales pueden incluso requerir tratamiento en unidades de cuidados intensivos. Hasta el momento, la reacción en cadena de la polimerasa con transcripción inversa y el cultivo celular son los métodos más usados para su diagnóstico. Se presentan los seis primeros casos de metapneumovirus humano en niños de Medellín, Colombia.
Human metapneumovirus is a newly discovered pathogen associated with respiratory disease and occurring mainly in children. It produces an acute viral respiratory disease picture that varies from mild disease to severe, and which can require strict surveillance in intensive care units. Currently, reverse transcriptase polymerase chain reaction and cell culture are the most common methods for its diagnosis. The first six cases of human metapneumovirus in Colombia are presented from Medellín.
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Metapneumovirus/isolation & purification , Paramyxoviridae Infections/virology , Pneumonia, Viral/virology , /therapeutic use , Hypoxia/etiology , Anti-Bacterial Agents/therapeutic use , Clarithromycin/therapeutic use , Colombia/epidemiology , Fever/etiology , Immunologic Tests , Paramyxoviridae Infections/complications , Paramyxoviridae Infections/diagnosis , Paramyxoviridae Infections/epidemiology , Paramyxoviridae Infections , Pneumonia, Mycoplasma/complications , Pneumonia, Mycoplasma/drug therapy , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Pneumonia, Viral , Reverse Transcriptase Polymerase Chain Reaction , Superinfection , Virus CultivationABSTRACT
Opsoclonus-myoclonus-ataxia syndrome (OMS) is a rare movement disorder characterized by chaotic saccadic, high amplitude, multidirectional and involuntary eye movements usually associated with myoclonus affecting the head, trunk, limbs and signs of cerebellar ataxia, especially the inability to stand and walk. We report a case of a 68 years-old woman, with previous history of diabetes mellitus and systemic hypertension that was referred for evaluation due to headache and low fever for three days. One day after the admission, she developed spatial and temporal disorientation and high-fever (39 °C). On her fourth day in-hospital, while still disoriented, diffuse limb myoclonia and intermittent, multidirectional and chaotic eye movements were noticed. Sorological tests and sputum Mycoplasma real-time PCR were positive on seventh day in-hospital. Patient was treated with Azithromycin and IV Immunoglobulin for five days. On third day after treatment it was noticed significant improvement of ataxia and myoclonia. Completely recovery after macrolydes and IVIg treatment, absence of a malignant neoplasia and knowledge of this entity in pediatric population support that parainfectious OMS associated with M. pneumoniae infections should be considered in the differential diagnosis of OMS in adults.
Subject(s)
Mycoplasma pneumoniae/immunology , Opsoclonus-Myoclonus Syndrome/diagnosis , Opsoclonus-Myoclonus Syndrome/microbiology , Pneumonia, Mycoplasma/diagnosis , Age Factors , Aged , Diagnosis, Differential , Female , Humans , Opsoclonus-Myoclonus Syndrome/immunology , Pneumonia, Mycoplasma/drug therapy , Pneumonia, Mycoplasma/microbiology , SyndromeABSTRACT
Mycoplasma pneumoniae produce 10 to 20 percent of atypical pneumonia, and secondarily affects by autoimmune mechanisms the central and peripheral nervous system. This presentation prospects to understand others pathologies than pneumonia, originated by mycoplasma pneumonia, like hemorrhagic cerebral microvasculitis, Bickerstaff syndrome and autoimmune hemolytic anemia expressed by an adolescent. They were an immunomimetic manifestation of this bacteria, same days after pulmonary box. The microvasculitis shows blood in the CSF, retinal hemorrhages and special MR imaging s. Protuberancia! syndrome was identified by a multidirectional nystagmus, facial diplegia, involvement of the sixth cranial nerve and quadriplegia with pyramidal signs. The autoimmune hemolytic anemia was the last complication. Generally all these syndromes have been isolated described in relation to this bacterial infection. In this case they occurred simultaneously. The cerebral vasculitis took a special way, apparently not described before with these characteristics. Our conclusions are that mycoplasma pneumoniae can affect simultaneously different parenchyma expressing immunomimetic responses.
El Mycoplasma neumoniae es una bacteria productora del 10 al 20 por ciento de las neumonías atípicas, que secundariamente y por patomecanismos inmunomiméticos afecta al sistema nervioso central y periférico. Con esta presentación se busca dar significado a las variadas alteraciones que originó una neumonía por mycoplasma en un adolescente, que además presentó una micro vasculitis cerebral hemorrágica, un síndrome de Bickerstaffy una anemia hemolítica autoimune, como expresión de una respuesta inmunomimética desencadenada por la bacteria, días después de cuadro pulmonar. La microvasculitis produjo presencia de sangre en el LCR, hemorragias retinianas y una RM con imágenes características. El síndrome rombencefálico se identificó por un nistagmus multidireccional, diplejia facial, compromiso del sexto par y cuadriparesia con signos piramidales, que secuencial mente se complicaron con una anemia hemolítica autoimune. Todos estos síndromes han sido descritos aisladamente en relación a esta infección bacteriana, sin embargo, en este caso se produjeron simultáneamente y la vasculitis cerebral tomó un modo especial, al parecer no descrito antes con esas características. Se concluye que el mycoplasma neumoniae puede afectar con respuestas inmunomiméticas diversos parénquimas simultáneamente.
Subject(s)
Humans , Male , Adolescent , Anemia, Hemolytic, Autoimmune/etiology , Encephalitis/etiology , Pneumonia, Mycoplasma/complications , Vasculitis, Central Nervous System/etiology , Anti-Bacterial Agents/therapeutic use , Mycoplasma pneumoniae , Pneumonia, Mycoplasma/drug therapyABSTRACT
A 28-year-old, hypertensive and hypercholesterolaemic patient, was referred to our emergency unit with a mild thoracic pain, productive cough and a body temperature of 37.3°C. Laboratory examinations showed normal white cell count and moderate elevation of C reactive protein (CRP). Later, the thoracic pain increased accompanied by shortness of breath. High D-dimer was detected. Positive lupic anticoagulant factor and anticardiolipin and antibodies anti-Mycoplasma pneumoniae were present and high titres of antinuclear factor. Recombinant tissue-type plasminogen activator plus heparin and vancomycin were administered due the high possibility of mycoplasma pneumonia associated with pulmonary thromboembolism. CRP increased to very high levels with very mild modification of white blood cells during the evolution. Thoracic tomography and pulmonary scintigraphy of the lungs confirmed the diagnosis. The patient responded well and he was discharged after 25 days medicated with hydroxychloroquine sulphate, warfarin and aspirin. At present date he is well (150 days).
Subject(s)
Antiphospholipid Syndrome/complications , Pneumonia, Mycoplasma/complications , Pulmonary Embolism/complications , Adult , Anti-Bacterial Agents/therapeutic use , Antibodies, Antiphospholipid/blood , Anticoagulants/therapeutic use , Antiphospholipid Syndrome/diagnosis , C-Reactive Protein/analysis , Diagnosis, Differential , Emergency Service, Hospital , Humans , Male , Mycoplasma pneumoniae , Pneumonia, Mycoplasma/diagnosis , Pneumonia, Mycoplasma/drug therapy , Pulmonary Embolism/diagnosis , Pulmonary Embolism/drug therapy , Vancomycin/therapeutic useABSTRACT
We report a case of severe hemolytic anemia following Mycoplasma pneumoniae infection in a 29-year-old male patient who was treated with azithromycin. Direct Coombs' test was strongly positive and the cold agglutinin titer was high, with anti-I specificity. Antimycoplasma antibody titer by complement fixation was high 1:10,240. The patient was discharged after 12 days of hospitalization in good health. He remains clinically well with no recurrence of jaundice.
Subject(s)
Anemia, Hemolytic, Autoimmune/etiology , Mycoplasma pneumoniae/isolation & purification , Pneumonia, Mycoplasma/complications , Adult , Anemia, Hemolytic, Autoimmune/diagnosis , Anemia, Hemolytic, Autoimmune/drug therapy , Anti-Bacterial Agents/therapeutic use , Azithromycin/therapeutic use , Humans , Male , Pneumonia, Mycoplasma/diagnosis , Pneumonia, Mycoplasma/drug therapy , Severity of Illness IndexSubject(s)
Adult , Humans , Male , Anemia, Hemolytic, Autoimmune/etiology , Mycoplasma pneumoniae/isolation & purification , Pneumonia, Mycoplasma/complications , Anemia, Hemolytic, Autoimmune/diagnosis , Anemia, Hemolytic, Autoimmune/drug therapy , Anti-Bacterial Agents/therapeutic use , Azithromycin/therapeutic use , Pneumonia, Mycoplasma/diagnosis , Pneumonia, Mycoplasma/drug therapy , Severity of Illness IndexABSTRACT
Mycoplasma pneumoniae is an important causative agent of respiratory infection in childhood. Although the infection caused by M. pneumoniae is classically described as benign, severe and life-threatening pulmonary and extrapulmonary complications can occur. This study describes the first case of septic shock related to M. pneumoniae in a child with necrotizing pneumonitis, severe encephalitis, and multiple organs involvement, with a favorable outcome after lobectomy and systemic corticosteroids.