2018 Volume 39 Issue 3 Pages 358-363
Mycoplasma pneumoniae is thought to be a common cause of pneumonia and acute pharyngitis. In contrast, reports of pneumonia with concurrent acute epipharyngitis are rare. Here, I report a case of pneumonia due to M. pneumoniae with concurrent acute epipharyngitis confirmed by endoscope. The patient was an 11-year-old girl who was examined due to main complaints of fever, sore throat and headache. Endoscopy revealed purulent exudate on the adenoid. The white blood cell count was 5300/μL and C-reactive protein level was 2.34 mg/dL. A rapid diagnostic test yielded a negative result for Streptococcus pyrogenes. The patient was put on acetaminophen on an as-needed basis and her condition was monitored. Two days later, the fever persisted with worsening of the dry cough and the patient was re-examined. A chest X-ray revealed a cloudy shadow in the right upper lung field. When a rapid diagnostic test for mycoplasma was performed on the throat, the result was positive. Thus, we suspected M. pneumoniae infection and administered clarithromycin for treatment. Two days later, the fever began to resolve. After a total of 10 days of treatment, the patient was cured. M. pneumoniae was detected in purulent exudate and a M. pneumoniae particle agglutination test of the paired sera showed a significant increase; therefore, mycoplasma infection was diagnosed. There are cases in which the first signs of mycoplasma infection are primarily headache due to acute epipharyngitis; thus, caution is required.
