FULMINANT MYCOPLASMA-PNEUMONIAE PNEUMONIA

The frequency of fulminant pneumonia due to Mycoplasma pneumoniae is r elatively rare despite the high prevalence of Mycoplasma species infec tion in the general population. We recently encountered such a case an d have reviewed the English-language literature on cases of M pneumoni ae pneumonia that have resulted in respiratory failure or death. Due t o host factors or on epidemiologic grounds, fulminant cases seem to be more common in young healthy adults, in males, and possibly in smoker s among the 46 patients we found. An enhanced host cellular immune res ponse may be responsible for the development of severe cases. A spectr um of small airways disease is characteristic, including cellular bron chiolitis and bronchiolitis obliterans with and without organizing pne umonia. Based largely on anecdotal experience, corticosteroid use may be salutary in patients with respiratory failure. For reasons that are not well known, the incidence of pulmonary thromboembolism is increas ed in fatal cases.