Severe acrocyanosis precipitated by cold agglutinin secondary to infection with Mycoplasma pneumoniae in a pediatric patient.

Abstract

This is the first report describing a severe form of cold agglutinin-induced acrocyanosis with cutaneous necrosis after Mycoplasma infection in a 9-year-old patient without any other severe symptoms and laboratory alterations. We also present the results of two non-invasive methods used to determine the viability of tissues, degree of tissue perfusion impairment, and the responsiveness of the microvasculature. Laser Doppler flowmetry and laser speckle contrast imaging, both suitable to measure tissue blood perfusion non-invasively, have been used in the diagnosis and follow-up of various peripheral vascular diseases. In our patient, we demonstrated remarkably reduced microcirculation before the treatment and a significant perfusion increase in the acral regions after pentoxifylline therapy. The investigational techniques were useful tools to assess and quantify the severity of peripheral perfusion disturbances and to monitor the efficacy of the treatment in our patient.

• Authors: Bernadett Mosdósi, Zoltán Nyul, Arnold Nagy, Kata Bölcskei, Tamás Decsi, Zsuzsanna Helyes
• Journal: Croatian medical journal (Croat Med J) Vol. 58 Issue 6 Pg. 424-430 (Dec 31 2017) ISSN: 1332-8166 [Electronic] Croatia
• PMID: 29308834 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Antibodies, Bacterial
• Cryoglobulins
• Hemagglutinins
• Vasodilator Agents
• cold agglutinins
• Clarithromycin
• Pentoxifylline

Topics

• Administration, Oral
• Anti-Bacterial Agents (therapeutic use)
• Antibodies, Bacterial (blood)
• Child
• Clarithromycin (therapeutic use)
• Cryoglobulins (adverse effects)
• Cyanosis (drug therapy, etiology)
• Drug Therapy, Combination
• Echocardiography
• Female
• Hemagglutinins (adverse effects)
• Humans
• Infusions, Intravenous
• Laser-Doppler Flowmetry
• Mycoplasma pneumoniae (isolation & purification)
• Pentoxifylline (therapeutic use)
• Pneumonia, Mycoplasma (complications, drug therapy, immunology)
• Vasodilator Agents (therapeutic use)