Daxboeck Florian, Eisl Bernhard, Burghuber Christofer, Memarsadeghi Mazda, Assadian Ojan, Stanek Gerold
Clinical Institute for Hygiene and Medical Microbiology, Division of Hospital Hygiene, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
Wien Klin Wochenschr. 2007;119(11-12):379-84. doi: 10.1007/s00508-007-0810-7.
A case of fatal Mycoplasma pneumoniae pneumonia in a previously healthy 18-year-old girl is reported. On hospital day 9, the antibody titer to M. pneumoniae was 1:512 in the complement fixation test and 1:5120 in the microparticle agglutination assay. After five weeks in the intensive care unit, the patient died from necrotizing hemorrhagic pneumonia with multi-organ failure. No significant superinfections occurred during ICU treatment. Corticosteroids (hospital day 8 onward) did not influence the course of the disease. It is noteworthy that, as in some previously reported cases, the clinical state deteriorated during presumably adequate antibiotic treatment (2 days before admission onward), and despite documented eradication of the pathogen from the respiratory tract (PCR from bronchoalveolar fluid on hospital day 22 was negative). However, the illness had lasted for several days before admission to the hospital, therefore the potentially beneficial effect of antibiotic treatment at an early stage of the disease cannot be assessed. Clearly, in default of other treatment options, correct diagnosis and early treatment of mycoplasma community-acquired pneumonia seems mandatory. This is the third case of fatal mycoplasma pneumonia reported from Austria in recent years, making this topic worthy of further scientific attention.
报告了一例先前健康的18岁女孩死于肺炎支原体肺炎的病例。在住院第9天，补体结合试验中肺炎支原体抗体滴度为1:512，微粒凝集试验中为1:5120。在重症监护病房治疗五周后，患者死于坏死性出血性肺炎并伴有多器官衰竭。在重症监护病房治疗期间未发生明显的二重感染。皮质类固醇（从住院第8天起）对疾病进程没有影响。值得注意的是，与一些先前报道的病例一样，在可能充分的抗生素治疗期间（入院前2天起）临床状况恶化，尽管呼吸道病原体已被证实清除（住院第22天支气管肺泡灌洗液的PCR检测为阴性）。然而，在入院前疾病已经持续了几天，因此无法评估疾病早期抗生素治疗的潜在有益效果。显然，在没有其他治疗选择的情况下，正确诊断和早期治疗支原体社区获得性肺炎似乎是必要的。这是近年来奥地利报告的第三例致命性支原体肺炎病例，使得该主题值得进一步科学关注。
