A Fulminant Case of Acute Respiratory Distress Syndrome Associated with Mycoplasma Pneumonia Treated with Nasal High-Flow Oxygen Therapy

Introduction. The prognosis of mycoplasma pneumonia in adults is generally favorable, but a few patients show progression to acute respiratory distress syndrome (ARDS). We have described the management of a patient who showed progression of mycoplasma pneumonia to ARDS. Presentation of Case. A 26-ye...

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Main Authors: Naoki Kawakami, Ho Namkoong, Takanori Ohata, Shinji Sakaguchi, Fumitake Saito, Hideki Yuki
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2018/1067593
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author Naoki Kawakami
Ho Namkoong
Takanori Ohata
Shinji Sakaguchi
Fumitake Saito
Hideki Yuki
author_facet Naoki Kawakami
Ho Namkoong
Takanori Ohata
Shinji Sakaguchi
Fumitake Saito
Hideki Yuki
author_sort Naoki Kawakami
collection DOAJ
description Introduction. The prognosis of mycoplasma pneumonia in adults is generally favorable, but a few patients show progression to acute respiratory distress syndrome (ARDS). We have described the management of a patient who showed progression of mycoplasma pneumonia to ARDS. Presentation of Case. A 26-year-old male patient with no significant past medical or social history presented with a 5-day history of fever. Following this, he was diagnosed with bacterial pneumonia and treated with tazobactam/piperacillin; however, he showed little clinical improvement with this treatment approach. We diagnosed the patient with mycoplasma pneumonia with an antigen test and treated him with azithromycin and prednisolone. Despite the appropriate antimicrobial therapy, his symptoms worsened and therefore we changed his oxygen therapy from a reservoir mask to nasal high-flow oxygen in addition to minocycline. Consequently, with this treatment, he recovered from severe mycoplasma pneumonia. Discussion. In patients with severe pneumonia who experience respiratory failure, it has been reported that nasal high-flow oxygen therapy is not inferior to noninvasive positive pressure ventilation therapy regarding intubation rate. In this case, induction of nasal high-flow oxygen therapy led to avoidance of ventilator management. This is a valuable case report highlighting the optimal outcome of nasal high-flow oxygen therapy in a fulminant case of acute respiratory distress syndrome. Conclusion. In patients who present with severe mycoplasma pneumonia with respiratory failure, nasal high-flow oxygen therapy can help reduce the needs for ventilator management including intubation.
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spelling doaj-art-8d80bb1df90f4efd9aa478e75ef5da642025-08-20T02:09:38ZengWileyCase Reports in Critical Care2090-64202090-64392018-01-01201810.1155/2018/10675931067593A Fulminant Case of Acute Respiratory Distress Syndrome Associated with Mycoplasma Pneumonia Treated with Nasal High-Flow Oxygen TherapyNaoki Kawakami0Ho Namkoong1Takanori Ohata2Shinji Sakaguchi3Fumitake Saito4Hideki Yuki5Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital, 9-1 Akashicho, Chuo-ku, Tokyo 104-8560, JapanDepartment of Pulmonary Medicine, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo 110-8645, JapanDepartment of Pulmonary Medicine, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo 110-8645, JapanDepartment of Pulmonary Medicine, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo 110-8645, JapanDepartment of Pulmonary Medicine, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo 110-8645, JapanDepartment of Pulmonary Medicine, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo 110-8645, JapanIntroduction. The prognosis of mycoplasma pneumonia in adults is generally favorable, but a few patients show progression to acute respiratory distress syndrome (ARDS). We have described the management of a patient who showed progression of mycoplasma pneumonia to ARDS. Presentation of Case. A 26-year-old male patient with no significant past medical or social history presented with a 5-day history of fever. Following this, he was diagnosed with bacterial pneumonia and treated with tazobactam/piperacillin; however, he showed little clinical improvement with this treatment approach. We diagnosed the patient with mycoplasma pneumonia with an antigen test and treated him with azithromycin and prednisolone. Despite the appropriate antimicrobial therapy, his symptoms worsened and therefore we changed his oxygen therapy from a reservoir mask to nasal high-flow oxygen in addition to minocycline. Consequently, with this treatment, he recovered from severe mycoplasma pneumonia. Discussion. In patients with severe pneumonia who experience respiratory failure, it has been reported that nasal high-flow oxygen therapy is not inferior to noninvasive positive pressure ventilation therapy regarding intubation rate. In this case, induction of nasal high-flow oxygen therapy led to avoidance of ventilator management. This is a valuable case report highlighting the optimal outcome of nasal high-flow oxygen therapy in a fulminant case of acute respiratory distress syndrome. Conclusion. In patients who present with severe mycoplasma pneumonia with respiratory failure, nasal high-flow oxygen therapy can help reduce the needs for ventilator management including intubation.http://dx.doi.org/10.1155/2018/1067593
spellingShingle Naoki Kawakami
Ho Namkoong
Takanori Ohata
Shinji Sakaguchi
Fumitake Saito
Hideki Yuki
A Fulminant Case of Acute Respiratory Distress Syndrome Associated with Mycoplasma Pneumonia Treated with Nasal High-Flow Oxygen Therapy
Case Reports in Critical Care
title A Fulminant Case of Acute Respiratory Distress Syndrome Associated with Mycoplasma Pneumonia Treated with Nasal High-Flow Oxygen Therapy
title_full A Fulminant Case of Acute Respiratory Distress Syndrome Associated with Mycoplasma Pneumonia Treated with Nasal High-Flow Oxygen Therapy
title_fullStr A Fulminant Case of Acute Respiratory Distress Syndrome Associated with Mycoplasma Pneumonia Treated with Nasal High-Flow Oxygen Therapy
title_full_unstemmed A Fulminant Case of Acute Respiratory Distress Syndrome Associated with Mycoplasma Pneumonia Treated with Nasal High-Flow Oxygen Therapy
title_short A Fulminant Case of Acute Respiratory Distress Syndrome Associated with Mycoplasma Pneumonia Treated with Nasal High-Flow Oxygen Therapy
title_sort fulminant case of acute respiratory distress syndrome associated with mycoplasma pneumonia treated with nasal high flow oxygen therapy
url http://dx.doi.org/10.1155/2018/1067593
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