Korean Circ J.  2012 Oct;42(10):709-713. 10.4070/kcj.2012.42.10.709.

A Case of Acute Myopericarditis Associated With Mycoplasma Pneumoniae Infection in a Child

• Park IH
• Choi DY
• Oh YK
• Kim JD
• Yu ST

• KMID: 1826470
• DOI: http://doi.org/10.4070/kcj.2012.42.10.709

Abstract

Mycoplasma pneumoniae (M. pneumoniae) primarily causes respiratory tract infections in persons aged 5-20 years. Tracheobronchitis and bronchopneumonia are the most commonly recognized clinical symptoms associated with M. pneumoniae infection. Complications of this infection are unusual; in particular, cardiac involvement is very rare and is generally accompanied by pneumonia. Nonrespiratory illness can therefore involve direct invasion by M. pneumoniae or autoimmune mechanisms, as suggested by the frequency of cross reaction between human antigens and M. pneumoniae. Herein, we report a case of severe acute myopericarditis with pneumonia caused by M. pneumoniae in a healthy young child who presented with fever, lethargy, oliguria and dyspnea. She survived with aggressive therapy including clarithromycin, intravenous immunoglobulin, inotropics, and diuretics. The patient was discharged on the 19th day after admission and followed up 1 month thereafter at the outpatient clinic without sequelae.

Keyword

Mycoplasma pneumoniae; Azithromycin; Clarithromycin; Pericarditis; Myocarditis

MeSH Terms

Aged
Ambulatory Care Facilities
Azithromycin
Bronchopneumonia
Child
Clarithromycin
Cross Reactions
Diuretics
Dyspnea
Fever
Humans
Immunoglobulins
Lethargy
Mycoplasma
Mycoplasma pneumoniae
Myocarditis
Oliguria
Pericarditis
Pneumonia
Pneumonia, Mycoplasma
Respiratory Tract Infections
Azithromycin
Clarithromycin
Diuretics
Immunoglobulins

Figure

• 

  Fig. 1 Pretreatment and post-treatment chest radiographic findings. A: bronchopneumonia, scanty parapneumonic effusion, and cardiomegaly (CT ratio, 0.66) was observed (HD#3). B: there was no abnormal finding after treatment, including heart size (HD#13). HD: hospital day.

• 

  Fig. 2 Pretreatment echocardiogram in apical 4-chamber view findings. A: pericardial effusion (arrow) was observed (HD#3). B: severe mitral regurgitation was observed (HD#3). C: there was no abnormal finding after treatment, including pericardial effusion (HD#16). HD: hospital day.

• 

  Fig. 3 Pretreatment (A: HD#3) and post-treatment (B: HD#16) echocardiogram in apical M-mode findings. HD: hospital day.

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