Tigecycline combined with bronchoscopic interventions in the treatment of macrolide-unresponsive Mycoplasma penumoniae pneumonia: A case report

Mycoplasma penumoniae (MP) is a common etiological agent of community-acquired pneumonia. However, there has been an increasing incidence of macrolide-unresponsive Mycoplasma penumoniae pneumonia (MUMPP) in recent years. The treatment of MUMPP requires further investigation. In this report, we describe a case of MUMPP complicated by secondary spontaneous pneumothorax. The patient was unresponsive to initial macrolide treatment and his pneumonia worsened with increasing hypoxemic respiratory failure. However, after receiving a novel tetracycline and a carbapenem antibiotic as anti-infective agents, glucocorticoid for anti-inflammatory and bronchoscopic interventions to clear the bronchial casts, his fever and hypoxia resolved, and his lung lesions had significantly improved. Symptomatic supportive measures, including supplemental oxygen, was provided for the management of spontaneous pneumothorax developed twenty days after discharge. At follow-up, he did not experience any more initial symptoms. All indexes remained normal for half a year. This study represents the initial investigation into the utilization of tigecycline in conjunction with bronchoscopic interventions including bronchoalveolar lavage (BAL) and bronchoscopic cryotherapy (BC) in the treatment of MUMPP, glucocorticoid can be considered for anti-inflammatory purposes, especially for patients with severe pneumonia. The findings from this case offer valuable insights into a potential therapeutic approach for individuals afflicted with MUMPP.