A child had a hemolytic anemia during the co-infection of Mycoplasma pneumoniae and adenovirus

We report a 3-year-old boy presenting with a 1-day history of red urine and jaundice. He had productive cough, rhinorrhea and nasal obstruction during the last 4 days and was febrile for 2 days. The laboratory tests indicated autoimmune hemolytic anemia. Chest radiography showed interstitial infiltration with haziness of the right lung. Oral macrolide (Zithromax) was given the first day on admission. The next day, a respiratory multiplex polymerase chain reaction (PCR) panel test revealed Mycoplasma pneumoniae and adenovirus co-infections. Oral prednisolone (1.1 mg/kg/day) was prescribed on hospital day 3 due to progressive anemia (7.2 g/dL). The fever subsided, and the patient showed a favorable recovery, and was discharged on the 6th day with an Hb level of 8.5 g/dL. The Hb level was elevated to 10.2 g/dL with a 7-day administration of oral prednisolone. M. pneumoniae was later confirmed by a blood test after discharge of both positive immunoglobulin IgG and IgM antibodies, indicative of a recent infection. We reported a child had a hemolytic anemia during the co-infection of Mycoplasma pneumoniae and adenovirus, and the use of multiplex polymerase chain reaction (PCR) viral and bacterial pathogens panel may provide an early evaluation and a timely therapeutic strategy for the patient.

關鍵字

Mycoplasma pneumoniae (M. pneumoniae) ； Polymerase chain reaction (PCR) ； Autoimmune hemolytic anemia (AIHA)

並列摘要

一名三歲男童，有紅色尿和黃疸，就醫前4天有大量咳嗽、流鼻涕和鼻塞，發燒2天。實驗室檢查顯示自體免疫溶血性貧血（Hb8.2g/dL），胸部X光片顯示右肺間質浸潤。入院第一天給予口服macrolide。第二天，呼吸道多重聚合酶連鎖反應（PCR）套組檢驗顯示肺炎黴漿菌和腺病毒合併感染，Hb降至7.2 g/dL，住院第3天處方口服類固醇prednisolone。住院第6天Hb 8.5 g/dL，恢復良好出院並持續口服prednisolone，一週回診Hb升至10.2 g/dL，在肺炎黴漿菌IgG和IgM抗體均呈陽性後，血液檢測確認爲最近感染。本文報導一例肺炎黴漿菌和腺病毒共同感染引起的自體免疫溶血性貧血，採用多重聚合酶連鎖反應套組同時鑑定病毒和細菌，可爲患者提供早期評估和即時治療策略。

並列關鍵字

肺炎黴漿菌；腺病毒；聚合酶連鎖反應；自體免疫溶血性貧血

國際替代計量

A child had a hemolytic anemia during the co-infection of Mycoplasma pneumoniae and adenovirus

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