SHM Converge Scientific Abstract ePoster Gallery-Myocarditis, Heart Failure, and Thrombus Caused by Mycoplasma Pneumoniae

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This case report describes a 32-year-old previously healthy man who developed serious cardiac complications after a Mycoplasma pneumoniae infection. He initially presented to the emergency department with 3 days of fever, anorexia, rash, weight gain, and dyspnea on exertion after recently traveling to Colorado. Examination showed a diffuse targetoid rash involving the palms and soles, and Mycoplasma IgM was positive.<br /><br />During hospitalization, he became acutely hypoxic. Chest imaging revealed bibasilar opacities, bilateral pleural effusions, and cardiomegaly. BNP was elevated to 1400, and transthoracic echocardiography showed a reduced ejection fraction of 25%. Cardiac MRI confirmed decreased left ventricular systolic function, myocarditis, and a left ventricular thrombus. He was treated with apixaban and diuresis, with improvement in dyspnea. Guideline-directed medical therapy for heart failure was started with losartan, spironolactone, and metoprolol succinate. Follow-up cardiac MRI showed resolution of the thrombus and improvement in left ventricular ejection fraction.<br /><br />The report highlights that M. pneumoniae is not only a cause of respiratory illness but can also lead to extrapulmonary manifestations, including rare but potentially severe cardiac involvement such as myocarditis, pericarditis, and thrombus formation. Proposed mechanisms include direct invasion, immune-mediated injury, and vascular occlusion.<br /><br />The key conclusion is that early recognition and treatment of Mycoplasma pneumoniae infection are important to reduce morbidity and mortality. This case emphasizes the need to consider M. pneumoniae in young patients with myocarditis or unexplained heart failure and to initiate appropriate antibiotics and heart failure therapy promptly.

Asset Subtitle

Victoria A. Kreyden

Meta Tag

Author List Shabbir Matcheswalla, Victoria A. Kreyden

Category Clinical Vignettes

Concept Mycoplasma pneumoniae

Concept Pneumonia

Concept Extrapulmonary Manifestation

Concept Myocarditis

Concept Antibiotic Therapy

Distinguished Non-Finalist

Presenter Organization The Ohio State University

Presenting Author Victoria A. Kreyden

Track Adult

Keywords

Mycoplasma pneumoniae

myocarditis

left ventricular thrombus

heart failure

reduced ejection fraction

cardiac MRI

pleural effusions

targetoid rash

apixaban

extrapulmonary manifestations

Mycoplasma pneumoniae

Pneumonia

Extrapulmonary Manifestation

Myocarditis

Antibiotic Therapy