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Atypical course of pneumonia with extrapulmonary complications due to Mycoplasma pneumoniae infection


Authors: R. Brnka;  I. Jurkovičová;  doc. MUDr. Emőke Šteňová, PhD.
Authors‘ workplace: Prednostka: doc. MUDr. Soňa Kiňová, PhD. ;  I. Interná klinika Lekárskej fakulty Univerzity Komenského a Univerzitnej nemocnice Bratislava
Published in: Prakt. Lék. 2012; 92(5): 294-296
Category: Case Report

Overview

Mycoplasma pneumoniae (M. pneumoniae) is an extracellular pathogen that penetrates the ciliated layer of the respiratory mucus and firmly adheres to the surface of the epithelial cells. It differs from other bacteria by not producing peptidoglycan and thereby not forming a firm cell wall. This close contact of cells and mycoplasmas allows for membrane fusion and the exchange of antigens, which explains many extrapulmonary complications from autoimmune reactions (Such as myocarditis, pericarditis, encephalitis, peripheral neuropathy, haemolytic anaemia, Stevens-Johnson syndrome, mucositis, epidermal necrolysis, myelitis, coagulopathy, erythema multiforme, macular rash, erythema nodosum, hepatocellular jaundice, acute pancreatitis, acute glomerulonephritis, renal failure, cholestatic hepatitis, even coma and others). M. pneumoniae is a common cause of upper respiratory tract infections, but it can take the course of atypical bronchopneumonia. Diagnosis can be confirmed with high probability by serological examination of antibody titre of immunoglobulin M (IgM), where an IgM antibody titre of 1:32 is considered highly significant. However, positivity is manifested in only 50–70 % of patients 7–10 days after the outbreak of disease. A negative result, however, does not exclude a possible ongoing infection.

Key words:
Mycoplasma pneumoniae, extrapulmonary symptoms, atypical pneumonia


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