A clinical case of community-acquired pneumonia of mycoplasmic etiology complicated by spontaneous mediastinal emphysema in a child with bronchial asthma

Introduction. In the period from October to December 2024, there was an increase in cases of community-acquired pneumonia in children caused by Mycoplasma pneumoniae in the Republic of Bashkortostan, which has important epidemiological and clinical consequences. Mycoplasma infections have a cyclical pattern of epidemics, frequent outbreaks in organized groups, and a significant seasonal pattern, which makes children particularly vulnerable. In children with bronchial asthma, mycoplasma infection can worsen the course of the disease, contributing to bronchial hyperreactivity and complications such as spontaneous mediastinal emphysema. Objective. The aim is to perform a clinical and pathogenetic analysis of the course of community-acquired pneumonia caused by Mycoplasma pneumoniae in a child with bronchial asthma complicated by spontaneous mediastinal emphysema.

Presentation of the clinical case. The case of a 15-year-old boy with bronchial asthma and polyvalent sensitization, who developed community-acquired pneumonia of mycoplasmic etiology with a complication in the form of spontaneous mediastinal emphysema, is presented. The clinical picture of the disease included a dry cough, chest pain, difficulty breathing, and fever. The laboratory confirmed the diagnosis of mycoplasma pneumonia with a positive PCR result for Mycoplasma pneumoniae. X-ray examination revealed signs of inflammation and emphysema. Complex therapy included antibiotics, anti-inflammatory drugs and inhalation therapy, which contributed to the positive dynamics and improvement of the patient’s condition.

Conclusion. The presented clinical case illustrates the specific course of community-acquired pneumonia of Mycoplasma etiology in a child with bronchial asthma complicated by spontaneous mediastinal emphysema. The combination of chronic airway inflammation and atypical bacterial infection contributed to the development of a severe complication. Timely diagnosis, including pathogen identification, comprehensive antibacterial and anti-inflammatory therapy, as well as maintenance of baseline asthma treatment, ensured a favorable clinical outcome and prevented adverse events.

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