Beyond Walking Pneumonia: A Rare Case of Mycoplasma Pneumonia Leading to Pleural Empyema
Abstract
Abstract Introduction Mycoplasma pneumoniae is a common pathogen responsible for Community-acquired pneumonia, commonly referred to as “walking pneumonia” because these patients are usually not very sick and patients most times do not require hospitalization. Mycoplasma pneumonia rarely causes empyema. This case report describes an unusual Mycoplasma pneumonia that necessitated hospitalization and was complicated by empyema. There have been very few reported cases of empyema caused solely by mycoplasma pneumoniae in the adult population in the literature. Case Report A 39-year-old Hispanic female with no significant past medical history presented with complaints of fever, chills, myalgia, and cough ongoing for 10 days. The patient was tachycardic, tachypneic, and febrile. She had an elevated WBC count of 33000 cells/ul. Chest CT scan showed moderate-to-large loculated left-sided pleural effusion with scattered infiltrates on the right lung lobe. Mycoplasma pneumonia PCR was positive in the blood and pleural fluid. Blood and pleural fluid cultures did not grow other bacteria. The serum mycoplasma IgM level was elevated at 1.06U/L. Ultrasound-guided chest tube placement was performed, and analysis of the pleural fluid was suggestive of empyema and Pleural fluid mycoplasma IgM PCR was 4.05 U/L. The patient was diagnosed with sepsis pneumonia and empyema due to Mycoplasma pneumoniae. The patient was empirically treated initially with Vancomycin and meropenem and later switched…
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