Medicine · 2025
Cholestatic hepatitis as a rare manifestation of Mycoplasma pneumonia in an adult: A case report.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Ahmad Muhammad Husnain, Gohar Ali, Qadri Haseeb Mehmood, Ahmed Bilal, Ali Masab, Ayman Ayesha, Khaliq Muhammad Waqar, Haider Shah Syed Saqlain
Аннотация
RATIONALE: Mycoplasma pneumonia, a common cause of community-acquired respiratory infections, is rarely linked to extrapulmonary complications like cholestatic hepatitis.
PATIENT CONCERNS: We report a case of a 48-year-old male who developed jaundice after a respiratory illness. Initial workup revealed cholestatic hepatitis with elevated bilirubin and liver enzymes, while common causes of hepatitis were ruled out.
DIAGNOSES: Elevated pro-B type natriuretic peptide levels initially raised suspicion for heart failure, but cardiac evaluations were unremarkable. Chest X-ray showed bilateral infiltrates and pleural effusion, suggesting an underlying respiratory infection. Given the patient's respiratory symptoms, an atypical pathogen was suspected. Polymerase chain reaction for M. pneumonia DNA confirmed the diagnosis.
INTERVENTIONS: The patient was treated with azithromycin, resulting in significant improvement.
OUTCOMES: One-month follow-up showed normalized liver function and resolution of symptoms.
LESSONS: This case demonstrates that hepatobiliary involvement of M. pneumonia can occur in the immunocompetent adult. By excluding the other causes of cholestatic hepatitis and comparing the results of impaired liver function test with clinical and radiological findings characteristic of M. pneumonia infection, hepatobiliary involvement of M. pneumonia infection was confirmed. Only a small number of adult instances of M. pneumonia-associated cholestatic hepatitis have been documented. This case adds to the scant literature on Mycoplasma-associated cholestatic hepatitis and highlights the necessity for physicians to rule out M. pneumonia as a differential diagnosis in patients with respiratory illness and hepatic dysfunction.
PATIENT CONCERNS: We report a case of a 48-year-old male who developed jaundice after a respiratory illness. Initial workup revealed cholestatic hepatitis with elevated bilirubin and liver enzymes, while common causes of hepatitis were ruled out.
DIAGNOSES: Elevated pro-B type natriuretic peptide levels initially raised suspicion for heart failure, but cardiac evaluations were unremarkable. Chest X-ray showed bilateral infiltrates and pleural effusion, suggesting an underlying respiratory infection. Given the patient's respiratory symptoms, an atypical pathogen was suspected. Polymerase chain reaction for M. pneumonia DNA confirmed the diagnosis.
INTERVENTIONS: The patient was treated with azithromycin, resulting in significant improvement.
OUTCOMES: One-month follow-up showed normalized liver function and resolution of symptoms.
LESSONS: This case demonstrates that hepatobiliary involvement of M. pneumonia can occur in the immunocompetent adult. By excluding the other causes of cholestatic hepatitis and comparing the results of impaired liver function test with clinical and radiological findings characteristic of M. pneumonia infection, hepatobiliary involvement of M. pneumonia infection was confirmed. Only a small number of adult instances of M. pneumonia-associated cholestatic hepatitis have been documented. This case adds to the scant literature on Mycoplasma-associated cholestatic hepatitis and highlights the necessity for physicians to rule out M. pneumonia as a differential diagnosis in patients with respiratory illness and hepatic dysfunction.