TY - JOUR
T1 - Prolonged Mycoplasma pneumoniae infection in an elderly patient with community-acquired pneumonia
AU - Takahashi, Takashi
AU - Morozumi, Miyuki
AU - Okada, Takafumi
AU - Chiba, Naoko
AU - Asami, Ryoko
AU - Murayama, Somay Y.
AU - Ubukata, Kimiko
PY - 2009/8
Y1 - 2009/8
N2 - An 81-year-old woman with no underlying systemic illness was hospitalized with fever, muscle weakness, and sputum without cough for 2 days. Chest imaging showed consolidation in the left lower lobe. Real-time polymerase chain reaction (PCR) for six respiratory bacteria and 12 respiratory viruses performed on sputum obtained on admission showed Mycoplasma pneumoniae DNA, with no evidence of other pathogens. M. pneumoniae was confirmed to be the causative agent by serologic data. Variation of mycoplasma quantity in subsequent sputa was analyzed because of persistent sputum production despite treatment with minocycline. Mycoplasma DNA gradually decreased, becoming undetectable 1 week after the completion of 2 weeks of minocycline therapy. Two weeks after the completion of the minocycline therapy, mycoplasma DNA in sputum was strongly detectable again, and oral treatment with clarithromycin was initiated. No pathogen DNA was detected during 2 weeks of clarithromycin therapy or at 2 weeks after completion of this therapy. Although susceptibility tests on three isolates (on admission, 1 week after starting minocycline, and 2 weeks after minocycline cessation), showed no resistance to minocycline or clarithromycin, the infection was, nonetheless, prolonged. Some elderly subjects with mycoplasma pneumonia may show a longer course than that in young persons with pneumonia.
AB - An 81-year-old woman with no underlying systemic illness was hospitalized with fever, muscle weakness, and sputum without cough for 2 days. Chest imaging showed consolidation in the left lower lobe. Real-time polymerase chain reaction (PCR) for six respiratory bacteria and 12 respiratory viruses performed on sputum obtained on admission showed Mycoplasma pneumoniae DNA, with no evidence of other pathogens. M. pneumoniae was confirmed to be the causative agent by serologic data. Variation of mycoplasma quantity in subsequent sputa was analyzed because of persistent sputum production despite treatment with minocycline. Mycoplasma DNA gradually decreased, becoming undetectable 1 week after the completion of 2 weeks of minocycline therapy. Two weeks after the completion of the minocycline therapy, mycoplasma DNA in sputum was strongly detectable again, and oral treatment with clarithromycin was initiated. No pathogen DNA was detected during 2 weeks of clarithromycin therapy or at 2 weeks after completion of this therapy. Although susceptibility tests on three isolates (on admission, 1 week after starting minocycline, and 2 weeks after minocycline cessation), showed no resistance to minocycline or clarithromycin, the infection was, nonetheless, prolonged. Some elderly subjects with mycoplasma pneumonia may show a longer course than that in young persons with pneumonia.
KW - Community-acquired pneumonia
KW - Drug susceptibility
KW - Elderly
KW - Mycoplasma pneumoniae
KW - Real-time PCR
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U2 - 10.1007/s10156-009-0692-x
DO - 10.1007/s10156-009-0692-x
M3 - Article
C2 - 19688244
AN - SCOPUS:69049098142
VL - 15
SP - 243
EP - 247
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
SN - 1341-321X
IS - 4
ER -