1141 Severe Refractory Pulmonary Complications in Children with Mycoplasma Pneumoniae Pneumonia

Wednesday, 14 October 2015
Hall D1 Foyer (Floor 3) (Coex Convention Center)

Sejin An, MD , Department of Pediatrics, Chungnam National University Hospital, Daejeon city, Jung-gu, South Korea

Jae Ho Lee, MD, PhD , Pediatrics, Chungnam National University School of Medicine, Daejeon city, South Korea

Jae Ho Lee, MD, PhD , Pediatrics, Chungnam National University School of Medicine, Daejeon city, South Korea

Background: M. pneumoniae is one of most common causes of community-acquired pneumonia in children. In the clinical courses, small portions are serious. The mechanisms of severe pulmonary complication of M. pneumonia pneumonia are not clear, but exaggerated immune reactions may play a major role in the destruction of lung tissues.

Methods: Two patients had severe respiratory symptoms and signs with high fever. The blood test, inflammatory reactant test and serologic test were performed. The mycoplasma pneumonia was confirmed by positive IgM and also rising titers of IgG antibody of M. pneumoniae or cold agglutinin more than four times later. The chest radiograph and computed tomography (CT) scan were checked serially.

Results: In one case of necrotizing pneumonia, 3-year-boy had protracted clinical course of high fever and moderate respiratory distress despite of the appropriate antibiotic therapy. A chest CT scan revealed profound lung tissue destruction in the right middle lobe. After 2 month of intensive antibiotic therapy, he was finally recovered completely without sequela. In case of bronchiolitis obliterance, 2-year-boy showed a patch infiltration in the right middle lobe. The mycoplasma pneumonia was effectively treated with appropriate antibiotics. After 3 month of discharge, the chest CT scan showed the segmental consolidation of the right middle lobe with bronchial wall thickening and hyper-lucency. He had recurrent pneumonia clinically and the right lung lesions were progress to be collapsed totally, called as destroyed lung till 3 years of infection. After 10 year of follow up, the chest CT scan was stationary without clinical problems.

Conclusions: We reported two cases of necrotizing pneumonia and bronchiolitis obliterance followed by destroyed lung after mycoplasma pneumoniae pneumonia.