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Microbiology II Case Study – Primary Atypical Pneumonia in a Child A 12-year-old girl was admitted with fever, a persistent nonproductive cough, and night sweats; she appeared mildly dyspneic. Four weeks previously, the patient had been well. During the course of illness, she experienced episodic pain in the subscapular region and shoulder. On admission her vital signs were: temperature - 38.5°C; pulse 98/min; respirations - 29/min; and blood pressure - 125/65 mm Hg. Other laboratory tests indicated a leukocyte count of 6.3 x 10^9/L, white blood cell populations within normal limits, an increased blood sedimentation rate and a high value for C-reactive protein. Chest radiographs showed bilateral lower lobe involvement. Blood cultures were negative and routine cultures of bronchial washings revealed no pathogens. An immunoblot for anti-I IgM was strongly positive and a complement fixation assay gave a serum antibody titer of >1:512 using M. pneumoniae antigen. Oral erythromycin and intravenous cefuroxime were administered. The patient turned afebrile within 2 days; improvement was slow, but uneventful. She was discharged from the hospital 5 days after admission. Questions: (3 points each) 1. What does the strong positive for IgM antibodies suggest? 2. Is a slow recovery typical for pneumonia due to M. pneumoniae? 3. Is the patient immune to M. pneumoniae after this episode of illness?

          Microbiology II Case Study – Primary Atypical Pneumonia in a Child

A 12-year-old girl was admitted with fever, a persistent nonproductive cough, and night sweats; she appeared mildly dyspneic. Four weeks previously, the patient had been well. During the course of illness, she experienced episodic pain in the subscapular region and shoulder. On admission her vital signs were: temperature - 38.5°C; pulse 98/min; respirations - 29/min; and blood pressure - 125/65 mm Hg. Other laboratory tests indicated a leukocyte count of 6.3 x 10^9/L, white blood cell populations within normal limits, an increased blood sedimentation rate and a high value for C-reactive protein. Chest radiographs showed bilateral lower lobe involvement. Blood cultures were negative and routine cultures of bronchial washings revealed no pathogens. An immunoblot for anti-I IgM was strongly positive and a complement fixation assay gave a serum antibody titer of >1:512 using M. pneumoniae antigen. Oral erythromycin and intravenous cefuroxime were administered. The patient turned afebrile within 2 days; improvement was slow, but uneventful. She was discharged from the hospital 5 days after admission.

Questions: (3 points each)

1. What does the strong positive for IgM antibodies suggest?

2. Is a slow recovery typical for pneumonia due to M. pneumoniae?

3. Is the patient immune to M. pneumoniae after this episode of illness?

Microbiology II Case Study – Primary Atypical Pneumonia in a Child

A 12-year-old girl was admitted with fever, a persistent nonproductive cough, and night sweats; she appeared mildly dyspneic. Four weeks previously, the patient had been well. During the course of illness, she experienced episodic pain in the subscapular region and shoulder. On admission her vital signs were: temperature - 38.5°C; pulse 98/min; respirations - 29/min; and blood pressure - 125/65 mm Hg. Other laboratory tests indicated a leukocyte count of 6.3 x 10^9/L, white blood cell populations within normal limits, an increased blood sedimentation rate and a high value for C-reactive protein. Chest radiographs showed bilateral lower lobe involvement. Blood cultures were negative and routine cultures of bronchial washings revealed no pathogens. An immunoblot for anti-I IgM was strongly positive and a complement fixation assay gave a serum antibody titer of >1:512 using M. pneumoniae antigen. Oral erythromycin and intravenous cefuroxime were administered. The patient turned afebrile within 2 days; improvement was slow, but uneventful. She was discharged from the hospital 5 days after admission.

Questions: (3 points each)

1. What does the strong positive for IgM antibodies suggest?

2. Is a slow recovery typical for pneumonia due to M. pneumoniae?

3. Is the patient immune to M. pneumoniae after this episode of illness?

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