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Mycoplasma pneumoniae lung abscess 775 First, the lung abscess remained despite treatment with various antibacterial agents, to all of which MSSA was susceptible but to which M. pneumoniae was resistant. Second, M. pneumoniaespecific PCR of the lung tissue obtained at lobectomy was positive, and particle agglutination titers for M. pneumoniae were increased 32-fold after 3 weeks. Third, radiology on admission already indicated the lung abscess. Finally, the patient developed cytokine storm, which is not uncommon during mycoplasma infection, but extremely rare during staphylococcal infection.7 Therefore, one can conclude that the lung abscess in the present case was caused by M. pneumoniae infection. The host immune response to M. pneumoniae plays a principal role in the pathogenesis of mycoplasma pneumonia. In the present case, however, the lung abscess might have been formed by the direct injury of M. pneumoniae.

Conclusion Mycoplasma pneumoniae infection must be taken into consideration when patients present with lung abscess resistant to betalactam antibiotics, and immunosuppressive treatment must be highly effective in the case of suspected hypercytokinemia.

References 1 Defilippi A, Silvestri M, Tacchella A, Giacchino R, Melioli G, Di Marco E. Epidemiology and clinical features of Mycoplasma pneumoniae infection in children. Respir. Med. 2008; 102: 1762–8. 2 Biondi E, McCulloh R, Alverson B, Klein A, Dixon A. Treatment of mycoplasma pneumonia: A systematic review. Pediatrics 2014; 133: 1081–90. 3 Moore C, Perry M, Cottrell S. The emerging role of community sentinel surveillance in the understanding of the clinical features and epidemiology of acute Mycoplasma pneumoniae infection. Clin. Microbiol. Infect. 2014; 20: O489–92. 4 Leonardi S, del Giudice MM, Spicuzza L, Saporito M, Nipitella G, La Rosa M. Lung abscess in a child with Mycoplasma pneumoniae infection. Eur. J. Pediatr. 2010; 169: 1413–15. 5 Chiou CC, Liu YC, Lin HH, Hsieh KS. Mycoplasma pneumoniae infection complicated by lung abscess, pleural effusion, thrombocytopenia and disseminated intravascular coagulation. Pediatr. Infect. Dis. J. 1997; 16: 327–9. 6 Yang J, Hooper WC, Phillips DJ, Talkington DF. Cytokines in Mycoplasma pneumoniae infections. Cytokine Growth Factor Rev. 2004; 15: 157–68. 7 Hoshino C, Satoh N, Sugawara S, Kuriyama C, Kikuchi A, Ohta M. Community-acquired Staphylococcus aureus pneumonia accompanied by rapidly progressive glomerulonephritis and hemophagocytic syndrome. Intern. Med. 2007; 46: 1047–53.

Patient Report

Burkitt lymphoma with unusual presentation: Acute pancreatitis Tugba Koca,1,* Nagehan Aslan,2 Selim Dereci1 and Mustafa Akcam2 1 Division of Pediatric Gastroenterology, Hepatology and Nutrition and 2Department of Pediatrics, School of Medicine, Süleyman Demirel University, Isparta, Turkey Abstract

Pancreatitis due to malignant infiltration is an uncommon condition in childhood. Pancreatic lymphomas constitute

Burkitt lymphoma with unusual presentation: Acute pancreatitis.

Pancreatitis due to malignant infiltration is an uncommon condition in childhood. Pancreatic lymphomas constitute ...
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