Lab Med Online.  2012 Oct;2(4):226-231.

Mycoplasma pneumoniae Pneumonia Unresponsive to Macrolide Treatment

• Ji M
• Sung H
• Shim TS
• Jang W
• Kim MN

Abstract

We present a case of community-acquired pneumonia (CAP) that developed in a previously healthy young woman. She was diagnosed with Mycoplasma pneumoniae pneumonia, but did not respond to macrolide treatment. The pathogens of CAP was examined using chest radiographs, computed tomography, and various laboratory tests including Mycoplasma IgG and IgM antibodies, blood and sputum cultures, and PCR for M. pneumoniae, Legionella pneumophila, and Chlamydophila pneumoniae. In this study, differential diagnosis of the pathogens and analysis of the mechanisms underlying their resistance to macrolide treatment were performed, and the results were discussed. After changing the antimicrobial to quinolone, the patients' clinical symptoms and radiographic findings improved, and she was discharged after 8 days.

Keyword

Community-Acquired Pneumonia; Mycoplasma pneumoniae; Macrolide; Resistance

MeSH Terms

Antibodies
Chlamydial Pneumonia
Chlamydophila pneumoniae
Diagnosis, Differential
Female
Humans
Immunoglobulin G
Immunoglobulin M
Legionella pneumophila
Mycoplasma
Mycoplasma pneumoniae
Pneumonia
Pneumonia, Mycoplasma
Polymerase Chain Reaction
Sputum
Thorax
Antibodies
Immunoglobulin G
Immunoglobulin M

Figure

• 

  Fig. 1 Chronological changes observed in chest radiographs. (A) 2 days prior to admission at the local clinic, (B) day 1 of hospitalization, (C) day 3 of hospitalization, (D) 2 weeks after discharge.

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  Fig. 2 Antimicrobial therapy and clinical course.

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  Fig. 3 Electropherograms obtained with 23S rRNA gene sequencing of Mycoplasma pneumoniae isolated from sputum. A2063G mutation is shown by arrows.

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