CASE REPORT article
Front. Pediatr.
Sec. Pediatric Infectious Diseases
Volume 13 - 2025 | doi: 10.3389/fped.2025.1608233
This article is part of the Research TopicMethods In Pediatric Infectious Diseases 2024View all 10 articles
Case Report: Refractory Mycoplasma pneumoniae Pneumonia Complicated by Pulmonary Embolism and Infarction in a Child
Provisionally accepted
- Dalian Women and Children’s Medical Center(Group), Dalian, China
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Mycoplasma pneumoniae (MP) is a significant pathogen of community-acquired pneumonia (CAP) in children, typically following a benign course. However, some cases may progress to severe or refractory MP pneumonia (SMPP or RMPP) and lead to thromboembolic complications. This report described a rare case of a 9-year-old boy with RMPP complicated by bilateral pulmonary embolism (PE) and pulmonary infarction. The patient initially presented with fever and cough. Despite 24 days of prior treatment at another hospital, including macrolide, carbapenem and tetracycline antibiotics and corticosteroids, he still remained febrile with persistent wheezing when transferred to our institution. Through some laboratory findings and contrast-enhanced chest computed tomography, he fulfilled the diagnostic criteria for both SMPP and RMPP, companied with PE with pulmonary infarction. A multidisciplinary therapeutic approach combining anti-infective agents (linezolid and moxifloxacin), anti-inflammatory therapy (methylprednisolone), and adjusted anticoagulation (low molecular weight heparin followed by rivaroxaban) led to rapid clinical improvement, normalization of inflammatory/coagulation markers. Complete resolution of PE was further demonstrated on 3-month follow-up imaging. Residual focal necrosis in the right lower lobe was observed. This case highlights the potential for severe thromboembolic events in pediatric RMPP and underscores the importance of early recognition of imaging features (e.g., vascular filling defects, wedge-shaped infarcts) and integrated multidisciplinary management to optimize outcomes.
Keywords: Refractory Mycoplasma pneumoniae, severe Mycoplasma pneumoniae, Pulmonary Embolism, Children, Infection
Received: 08 Apr 2025; Accepted: 21 May 2025.
Copyright: © 2025 Zhang, Zhang, Zhu, Cheng and Shan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yuxia Shan, Dalian Women and Children’s Medical Center(Group), Dalian, China
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