Cold agglutinin syndrome associated with a pediatric severe systemic mycoplasma pneumoniae infection

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Cold agglutinin syndrome associated with a pediatric severe systemic Mycoplasma pneumoniae infection

Sara Geitoeira¹, Inês Paiva Ferreira², Ana Lachado³, Lurdes Morais⁴, Paula Cristina Fernandes⁵, Emília Costa³, Esmeralda Cleto³, Isabel Couto Guerra³.

¹Pediatrics, Unidade Local de Saúde de Viseu Dão-Lafões, Viseu, Portugal,
²Pediatrics, Unidade Local de Saúde do Tâmega e Sousa, Penafiel, Portugal,
³Pediatric Hematology, Unidade Local de Saúde de Santo António, Porto, Portugal,
⁴Pediatric Pneumology, Unidade Local de Saúde de Santo António, Porto, Portugal,
⁵Pediatric Intensive Care Unit, Unidade Local de Saúde de Santo António, Porto, Portugal.

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Why this article important?

This case report serves as a reminder that Mycoplasma pneumoniae infections can present with atypical features and severe complications. Healthcare providers should maintain a high index of suspicion for this pathogen, especially in cases of pneumonia with extrapulmonary manifestations. Publishing this case report serves several important purposes, such as expanding medical knowledge about Mycoplasma pneumonia’s less common but serious complications and about its clinical presentation, since it provides a detailed description of a complex clinical presentation, helping clinicians recognize and diagnose similar cases. This case report also shares information about effective treatment strategies, such as cold avoidance, for managing autoimmune hemolytic anemia associated with Mycoplasma pneumoniae.

Summary of article

This case report highlights the versatility of Mycoplasma pneumoniae as a respiratory pathogen, capable of causing a spectrum of disease ranging from mild upper respiratory infections to severe, systemic illness. While typically associated with a relatively benign clinical course, this case demonstrates the potential for M. pneumoniae to induce severe pneumonia and extrapulmonary manifestations, such as autoimmune hemolytic anemia. The development of cold agglutinin syndrome in this adolescent patient is particularly noteworthy. This rare complication, characterized by the production of cold-reactive antibodies that cause red blood cell destruction, underscores the complex interplay between infection and autoimmune processes. The successful management of this patient's anemia through cold avoidance measures emphasizes the importance of a tailored approach to the treatment of patients with M. pneumoniae infections.

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