An elderly patient with hemophagocytic syndrome due to severe mycoplasma pneumonia with marked hypercytokinemia.

We present an extremely rare case of hemophagocytic syndrome (HPS) induced by fulminant Mycoplasma pneumoniae (Mp) pneumonia in an elderly adult. Erythrocytopenia and thrombocytopenia were observed in a patient with acute respiratory failure, liver dysfunction and renal failure. Mp-associated HPS was diagnosed in this case by clinical and laboratory findings, including a bone marrow aspiration specimen and serum Mp antibody titer. High serum levels of soluble interleukin-2 receptor, interleukin-6, human interleukin-10 and macrophage-colony stimulating factor were observed. Hypercytokinemia is a useful marker of disease activity and prognosis. Combined treatment with methylprednisolone and erythromycin was successful and led to a favorable outcome. Physicians should be aware of HPS as a complication in Mp infection.