Thrombotic thrombocytopenic purpura in a case of mycoplasma pneumoniae

A 25-year-old man had four days of fever, vomiting, diarrhea and shortness of breath. On admission he had evidence of severe pneumonia with hypotension not responding to fluid challenges, needing ICU care with cardiorespiratory support. He developed thrombocytopenia, anemia, right sided weakness and renal impairment with normal coagulation profile and high LDH. Mycoplasma antibody titer rose with the disease course. We made a diagnosis of thrombotic thrombocytopenic purpura secondary to mycoplasma pneumoniae. With plasma exchange therapy, he made a remarkable recovery. This case illustrates a rare association of mycoplasma pneumoniae and thrombotic thrombocytopenic purpura, and the importance of initiation of appropriate therapy when it is suspected. DOI: http://dx.doi.org/10.4038/jccp.v41i2.3772 Journal of the Ceylon College of Physicians , 2010, 41, 89-91