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PEDIATRICS Vol. 105 No. 2 February 2000, pp. 433-436

EXPERIENCE AND REASON:
Rhabdomyolysis Associated With Infection by Mycoplasma pneumoniae: A Case Report

Received Apr 12, 1999; accepted Jul 21, 1999.

Rachel Pardes Berger* and Robert M. WadowksyDagger

* Department of Pediatrics Dagger  Department of Pathology Children's Hospital of Pittsburgh Pittsburgh, PA 15213

Background.  Mycoplasma pneumoniae is responsible for approximately 20% of the cases of community-acquired pneumonia. The onset of respiratory symptoms is gradual and systemic complaints such as headache, malaise, arthalgias, and low-grade fever are frequently prominent. Extrapulmonary manifestations of M pneumoniae are common and hematologic (thrombocytopenia, splenomegaly, disseminated intravascular coagulation, hemolytic anemia), dermatologic (Stevens-Johnson syndrome), gastrointestinal (vomiting, diarrhea, pancreatitis), renal (interstitial nephritis, glomerulonephritis), cardiac (pericarditis, myocarditis, pericardial effusion) and central nervous system (meningitis, transverse myelitis, polyradiculopathy, cerebellar ataxia, sensorineural hearing loss) complications can occur.1-3

Observation.  We describe the case of an adolescent girl with massive rhabdomyolysis associated with an infection caused by M pneumoniae. We briefly review the differential diagnosis of a patient presenting with acute rhabdomyolysis and discuss the use of a new polymerase chain reaction-based assay for direct detection of M pneumoniae in throat swab specimens.

Conclusion.  Clinicians should be aware of a possible association between rhabdomyolysis and infection with M pneumoniae and should consider testing for M pneumoniae when they are presented with a patient with idiopathic rhabdomyolysis. The new polymerase chain reaction-based assay for detection of M pneumoniae is a more accurate and more efficient method than traditional culture.  Key words:  Mycoplasma pneumoniae, rhabdomyolysis.


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