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Acute renal failure associated with Mycoplasma pneumoniae

Serkan Öncü, Avar Özdemir, Ayper Somer, Nuran Salman, Isık Yalcın, Nilgün Isık, Faruk Ökten

CaseRepClinPractRev 2002; 3(2):82-85

ID: 474535

Background: M. pneumoniae is a common cause of respiratory infections. Although the clinical course of M. pneumoniae infection is often mild and self-limiting, its extrapulmonary manifestations are common. Despite
the fact that a wide range of extrapulmonary manifestations have been described, their association with acute renal failure has been only sporadically reported.
Case report: A 7-year-old boy who was diagnosed to have pneumonia, diarrhea, hepatitis, thrombocytopenia and encephalitis developed acute renal failure on the fourth day after hospital admission due to Mycoplasma
pneumoniae infection. Despite the fact that there was neither prerenal cause nor nephrotoxic agent use, the patient had progressive decline of renal function. Renal failure resolved over the course of 2 weeks with appropriate
treatment. At the end of 3rd week after admission to hospital all the symptoms disappeared and all the laboratory values returned to normal limits. The diagnosis of Mycoplasma pneumoniae infection was made on the
basis of the clinical picture and a significant rise in mycoplasma complement response titer.
Conclusion: This patient developed pneumonia, diarrhea, cerebellar ataxia, hallucinations, hepatitis, thrombocytopenia, and acute renal failure. All these features are recognized sequelae of mycoplasma infection, but it is
rare to see an illness of such severity. Renal involvement in patients with pneumonia caused by M. pneumoniae is rare. Although we could not demonstrate the pathological changes in kidneys, the picture of renal involvement seems to be an interstitial nephritis. In our patient all symptoms resolved with adequate antibiotic treatment without dialysis and the use of steroids.

Keywords: Mycoplasma, renal failure

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