Atypical pneumonia: mycoplasma

Case contributed by Alborz Jahangiri
Diagnosis certain


2 weeks dry cough in a non-smoker

Patient Data

Age: 30 years
Gender: Female

Pulmonary aeration is significantly increased bilaterally. There is marked bronchial wall thickening on the right and left in the perihilar zone extending to the lung base in keeping with inflammatory lower airways disease. There are non-segmental patchy lung opacities in the lower lobes bilaterally (right lower lobe posterior basal segment; left lower lobe anterior basal segment; right middle lobe medial segment). There are also increased interstitial markings with lower zone predominance.

Case Discussion

The chest radiograph shows patchy non-segmental opacities bilaterally suggestive of atypical pneumonia. Given the patient's age and radiographic manifestation, chlamydia and mycoplasma are the likely causative organisms. Viral (including COVID-19) and fungal pathogens may also create the radiological and clinical picture of an atypical pneumonia.

The nasal swab DNA PCR was positive for Mycoplasma pneumoniae in this patient which correlated with the imaging findings.

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