Respiratory Stress Syndrome Case Studies

A rare cause of Acute Respiratory Distress Syndrome (ARDS) -

Mycoplasma pneumonia in a middle aged women

Case History

A 66-year-old female presented to the Emergency Department of Sri Jayewardenepura General hospital with generalized weakness, faintness, and progressive worsening of difficulty in breathing over a week prior to admission. She also had dry non-productive cough, general malaise with myalgia and a low grade fever. She had consulted a GP and treated with salbutamol and steroid inhalers on outpatient basis. However, since her symptoms became more and more troublesome, she was admitted to the hospital. She is a diagnosed patient with type 2 diabetes mellitus for last 10 years and was taking oral metformin for the control. Her glycemic control was not satisfactory and she was told that her renal functions were slightly impaired since last year. Latest creatinine clearance done 3 months back was 60 mg/dl/min.

Physical examination revealed a mild hypoxia and tachypnea with mild respiratory distress. Her vital signs were; temperature - 103.7 0F, pulse rate - 126/min, respiratory rate - 28/min, blood pressure - 139/82mmHg and SpO2 of 81% on room air. Cardiovascular examination and abdominal examination were normal. However, Respiratory system examination revealed diffuse bilateral coarse crepitation in all fields with reduced breath

Person to person transmission of M. pneumonia is mainly from infected respiratory droplets during close contact. However, incubation period of M. pneumoniae is one to three weeks owing to the slow generation time (six hours) of pathogen [2,3]. This relative long incubation period also tends to play a major role during an episodic outbreak of M. pneumonia. Recent data has shown that rates of M. pneumoniae infection among military recruits’ ranges from 25 to 71% in a semi-enclosed setting