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Clinical Case Study (Poster Session)

(P24-007-25) Emerging Resistance to Mycoplasma pneumoniae and Its Association With Malnutrition

Monday, June 2, 2025
11:45 AM - 12:45 PM ET
Location: Poster Board D-51

    Presenting Author(s)

  • SS

    Srishti Sankrityayan, n/a

    Student
    JSS Academy of Higher Education and Research, JSS Medical College and Hospital, Department of Paediatrics
    Mysuru, Karnataka, India

    • Co-Author(s)

  • SS

    Srushty Suresh

    JSS Academy of Higher Education and Research, JSS Medical College and Hospital, Department of Paediatrics, India

  • PS

    Prashanth S. N.

    JSS Academy of Higher Education and Research, JSS Medical College and Hospital, Department of Paediatrics, India

  • PV

    Prajwala H. Vasudev

    JSS Medical College, JSSAHER, Department of Paediatrics, India

  • SJ

    Stuti Jajodia (she/her/hers)

    Student
    JSS Academy of Higher Education and Research, JSS Medical College and Hospital, Department of Paediatrics
    Mysuru, Karnataka, India

Disclosure(s):
Stuti Jajodia: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Mycoplasma pneumonia (MP) is a leading cause of community-acquired pneumonia (CAP), particularly in children over 5 years old. Although macrolides are first-line treatments, some patients experience persistent symptoms and worsening disease, raising concerns about antibiotic resistance. Obesity is an independent risk factor for CAP due to impaired lung function and gas exchange, leading to worse outcomes.

Methods: A 13-year-old obese male presented with a 7-day history of persistent cough, 8-day fever, and hypoxemia (O2 saturation 88%). Clinical examination revealed fever, tachypnea, tachycardia, chest retractions, and crackles. Chest X-ray showed multifocal consolidation indicative of severe pneumonia and USG thorax confirmed the same. Initial treatment with piperacillin-tazobactam and vancomycin was started. HRCT revealed bilateral pleural effusion. On day 6, with no improvement, atypical organisms were suspected, and a cold agglutinin test was positive. The patient was switched to intravenous azithromycin, but after 5 days with no progress, doxycycline was initiated. The child improved clinically within 4 days, was discharged on day 8, and continued doxycycline for 10 days.

Here in our case after 5 days of intravenous azithromycin there was no improvement, hence considering possible resistance to first-line drugs, doxycycline was started.

Results: The child showed clinical improvement after 4 days of doxycycline, with reduced oxygen requirement and discontinued on day 8 of hospital stay and hence tab. Doxycycline was continued for 10 days. Thinking in terms of atypical organisms is correct because, typically, we would focus on Extended-spectrum beta-lactamase bacteria and use imipenem, which can often be avoided.

Conclusions: Obesity in children increases the risk of community-acquired pneumonia (CAP) by impairing immune function, similar to malnutrition. This creates a cycle where malnutrition and infections, like CAP, exacerbate each other, compromising health and development. Understanding this multifaceted relationship is essential for tailoring prevention and management strategies for community acquired pneumonia in obese individuals, particularly in populations with rising obesity rates and emerging resistance.

Funding Sources: None