Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2020; 8(23): 6080-6085
Published online Dec 6, 2020. doi: 10.12998/wjcc.v8.i23.6080
Fourty-nine years old woman co-infected with SARS-CoV-2 and Mycoplasma: A case report
Zi-Ang Gao, Ling-Bao Gao, Xin-Jie Chen, Yu Xu
Zi-Ang Gao, Yu Xu, Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
Ling-Bao Gao, Department of Transfusion, Taizhou People's Hospital, Taizhou 225300, Jiangsu Province, China
Xin-Jie Chen, Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
Author contributions: Gao ZA and Gao LB contributed equally to this work and should be regarded as co-first authors; Gao ZA and Gao LB collected clinical data, discussed the details and wrote this article together; Chen XJ analyzed and interpreted the patient data regarding CoVID-19; Xu Y analyzed the data, modified the manuscript and was a major contributor in writing the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review from the Editor of this journal.
Conflict-of-interest statement: We declare that we have no conflict of interest.
CARE Checklist (2016) statement: We have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu Xu, MD, PhD, Professor, Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuhan 430060, Hubei Province, China. xuy@whu.edu.cn
Received: May 28, 2020
Peer-review started: May 28, 2020
First decision: September 23, 2020
Revised: October 6, 2020
Accepted: October 27, 2020
Article in press: October 27, 2020
Published online: December 6, 2020
Processing time: 190 Days and 3.3 Hours
Abstract
BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new virus responsible for the outbreak of respiratory illness known as coronavirus disease 2019 (CoVID-19). Mycoplasma is an uncommon co-infected pathogen with SARS-CoV-2 and has not yet been reported. Computed tomography (CT), used as an accessory examination, may play a more significant role in this co-infection.

CASE SUMMARY

A 49-year-old female presented with a cough, expectoration and chest congestion followed by elevated C-reactive protein and erythrocyte sedimentation rate. CT images showed ground-glass opacities in bilateral lower lobes and a patchy and striate shadow in the right upper lobe. Immunoglobulin M antibody of Mycoplasma pneumoniae was positive and real-time fluorescence polymerase chain reaction of sputum was positive for SARS-CoV-2 nucleic acid. The diagnosis of CoVID-19 was made based on laboratory results, chest CT images, clinical manifestations and epidemiologic characteristics. She was treated with combination therapy for 17 d and showed a marked reCoVery.

CONCLUSION

Co-infection with SARS-CoV-2 and Mycoplasma in CoVID-19 patients appears to be uncommon. CT is an acceptable method for the primary diagnosis and treatment should be initiated as soon as possible. Combination therapy with antiviral, anti-inflammatory, traditional Chinese herbal medicine and interferon inhalation may be a reference for further progress in treating this co-infection.

Keywords: CoVID-19; SARS-CoV-2; Mycoplasma; Co-infection; Computed tomography; Infectious disease; Case report

Core Tip: In this study, we evaluated the disease evolution of a 49-year-old lady co-infected with severe acute respiratory syndrome coronavirus 2 and Mycoplasma. This co-infection is rare and her computed tomography (CT) images showed both typical manifestations of coronavirus disease 2019 and untypical findings which suggested Mycoplasma infection. Although the disease developed rapidly, with early intervention and treatment, we successfully prevented her from becoming worse. Clinical improvement on CT images suggested that our combination therapy of antiviral, anti-inflammatory, traditional Chinese herbal medicine and interferon inhalation may be an effective early treatment and a reference for further progress in treating this co-infection.