Mycoplasma pneumonia with severe cold agglutinin hemolysis, thrombocytosis, leukemoid reaction and acute renal failure

Johan Widén; Göran Jönsson; Ulf Karlsson

doi:10.1016/j.idcr.2023.e01689

Mycoplasma pneumonia with severe cold agglutinin hemolysis, thrombocytosis, leukemoid reaction and acute renal failure

IDCases. 2023 Jan 13:31:e01689. doi: 10.1016/j.idcr.2023.e01689. eCollection 2023.

Authors

Johan Widén^{1

2}, Göran Jönsson^{1

2}, Ulf Karlsson^{1

2}

Affiliations

¹ Department of Infectious Diseases, Skåne University Hospital, Lund, Hälsogatan 3, 221 85 Lund, Sweden.
² Department of Clinical Sciences, Section for Infection Medicine, Lund University, Lund, Sweden.

Abstract

Mycoplasma pneumoniae (M. pneumoniae) is a common cause of community acquired pneumonia and although most cases are mild, complications sometimes occur. Cold agglutinin hemolysis is a known complication of M. pneumoniae infection, and usually presents as a mild and transient hemolysis. Here we present a case of infection with M. pneumoniae in a 64-year-old male that caused life threatening hemolysis that required multiple blood transfusions. The patient also presented with acute kidney failure and a marked leukemoid reaction and thrombocytosis. This is a very rare combination of symptoms that could have led the clinicians to suspect a more virulent etiology than M. pneumoniae, thereby delaying adequate antibiotic treatment.

Keywords: Acute kidney failure; Cold-agglutinin hemolysis; Corticosteroids; Leukemoid reaction; Mycoplasma pneumoniae.

Publication types

Case Reports