ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
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Mycoplasma Pneumonia: A Rare Cause of Acute Pericarditis and Cardiac Tamponade
Session Title
TP58 - TP058 INFECTIONS IN THE ICU: CASE REPORTS
Abstract
A2951 - Mycoplasma Pneumonia: A Rare Cause of Acute Pericarditis and Cardiac Tamponade
Author Block: A. Al Tkrit, F. Alawawdeh, M. Aneeb, A. Mekaiel, H. Awad; Internal Medicine, Jamaica Hospital Medical Center, Richmond Hill, NY, United States.
Introduction Mycoplasma pneumonia is an atypical bacterium that is one of the most common respiratory pathogens associated with the development of community-acquired pneumonia that may also present with numerous extrapulmonary manifestations. Acute pericarditis, pericardial effusions, and cardiac tamponade is a rare complication associated with this pathogen. We present a case of Mycoplasma pneumonia-associated acute pericarditis that was followed by the development of cardiac tamponade in a young patient. Case Report A 19-year-old man presented to the ED with worsening substernal chest pain, nonproductive cough, epigastric pain, and two episodes of non-bloody vomiting for the last three days. He was hemodynamically stable with an unremarkable physical examination. EKG revealed sinus tachycardia, shortening of the PR interval, PR depression, and diffuse ST-segment elevation. CXR showed patchy reticulonodular opacities bilaterally and Cardiomegaly. Laboratory showed a troponin I was 0.010 ng/mL. He was admitted for the management of acute pericarditis and was started on ibuprofen and colchicine. The next day, he developed sudden loss of consciousness, diaphoresis, cold and clammy skin, BP 94/67 mmHg, HR 140 beats/min. Urgent CT pulmonary angiogram showed patchy opacities in bilateral lower lobes, bilateral pleural effusions, and a large complex pericardial effusion. With the clinical evidence of cardiac tamponade, emergent pericardiocentesis, and placement pigtail catheter performed for him. A total of 1000 ml of bloody fluid was removed, causing an immediate improvement in the hemodynamic status. Later, Echocardiography showed a normal ejection fraction of 55-60% without any regional wall motion abnormalities and with a small pericardial effusion. The drain catheter was removed after three days of pericardiocentesis. Serological studies were positive for IgM antibodies of Mycoplasma pneumonia. He was started on doxycycline for a total duration of 14 days, along continued with ibuprofen and colchicine. The patient remained stable and was discharged in a stable condition. Conclusion Mycoplasma pneumonia-associated pericarditis is a rare but serious condition that may result in the development of life-threatening cardiac tamponade. A high degree of clinical suspicion is required for the prompt identification of this pathogen as the underlying cause of pericardial disease. Serological testing may aid in the early detection of the pathogen and may be considered in the routine evaluation of patients with acute pericarditis, pericardial effusions, or cardiac tamponade who present with respiratory symptoms, or have a recurrent or refractory clinical course. Early initiation of antibiotics targeting Mycoplasma pneumonia is important and may prevent the development of long-term cardiac complications.
Author Block: A. Al Tkrit, F. Alawawdeh, M. Aneeb, A. Mekaiel, H. Awad; Internal Medicine, Jamaica Hospital Medical Center, Richmond Hill, NY, United States.
Introduction Mycoplasma pneumonia is an atypical bacterium that is one of the most common respiratory pathogens associated with the development of community-acquired pneumonia that may also present with numerous extrapulmonary manifestations. Acute pericarditis, pericardial effusions, and cardiac tamponade is a rare complication associated with this pathogen. We present a case of Mycoplasma pneumonia-associated acute pericarditis that was followed by the development of cardiac tamponade in a young patient. Case Report A 19-year-old man presented to the ED with worsening substernal chest pain, nonproductive cough, epigastric pain, and two episodes of non-bloody vomiting for the last three days. He was hemodynamically stable with an unremarkable physical examination. EKG revealed sinus tachycardia, shortening of the PR interval, PR depression, and diffuse ST-segment elevation. CXR showed patchy reticulonodular opacities bilaterally and Cardiomegaly. Laboratory showed a troponin I was 0.010 ng/mL. He was admitted for the management of acute pericarditis and was started on ibuprofen and colchicine. The next day, he developed sudden loss of consciousness, diaphoresis, cold and clammy skin, BP 94/67 mmHg, HR 140 beats/min. Urgent CT pulmonary angiogram showed patchy opacities in bilateral lower lobes, bilateral pleural effusions, and a large complex pericardial effusion. With the clinical evidence of cardiac tamponade, emergent pericardiocentesis, and placement pigtail catheter performed for him. A total of 1000 ml of bloody fluid was removed, causing an immediate improvement in the hemodynamic status. Later, Echocardiography showed a normal ejection fraction of 55-60% without any regional wall motion abnormalities and with a small pericardial effusion. The drain catheter was removed after three days of pericardiocentesis. Serological studies were positive for IgM antibodies of Mycoplasma pneumonia. He was started on doxycycline for a total duration of 14 days, along continued with ibuprofen and colchicine. The patient remained stable and was discharged in a stable condition. Conclusion Mycoplasma pneumonia-associated pericarditis is a rare but serious condition that may result in the development of life-threatening cardiac tamponade. A high degree of clinical suspicion is required for the prompt identification of this pathogen as the underlying cause of pericardial disease. Serological testing may aid in the early detection of the pathogen and may be considered in the routine evaluation of patients with acute pericarditis, pericardial effusions, or cardiac tamponade who present with respiratory symptoms, or have a recurrent or refractory clinical course. Early initiation of antibiotics targeting Mycoplasma pneumonia is important and may prevent the development of long-term cardiac complications.
