Mycoplasma pneumoniae pneumonia complicated by cold agglutinin hemolytic anemia

Abstract

We present the case of a 36 years old female patient, who consults for respiratory symptoms during two weeks, with admission diagnosis of community-acquired pneumonia. The clinical course was complicated by hemolytic anemia by cold hemagglutinin that suggests pneumonic infection by Mycoplasma pneumoniae, confirmed by serology. After short course of oral prednisone, folic acid and antibiotic therapy, resolution of anemia and clinical improvement of the pneumonia were obtained. This case report highlights the high temperature range of cold agglutinins as a condition for generating immune hemolysis and the absence of compensatory reticulocytosis of hemolysis, which are rare pneumonia complications of Mycoplasma pneumoniae, but that are determinants of the severity of the anemia. It also emphasizes the usefulness of cold agglutinin titers in the diagnosis of community-acquired pneumonia due to Mycoplasma pneumoniae