Echocardiographic Characteristics of Cardiac thrombus in Patients With
Mycoplasma pneumoniae infection
Sun Yan1, Zhang Ning2, Yang
Jiao1, Liu Guowen1,Li
Jingya1, Zhang Hongju1, Xue
Li1, Xu Liyuan1, Ma
Ning1*
1 Department of Ultrasound,Beijing Children’s Hospital, Capital Medical
University,National Center for children’s Health;2 Emergency General
Hospital
Corresponding author: Ma Ning
Institute: Department of Ultrasound,Beijing Children’s Hospital,
Capital Medical University,National Center for children’s Health
Address: No. 56 Nan Lishi Road, Xicheng District, Beijing 100027,
People’s Republic of China.
Tel 008615110236678
E-mail Maning_echo@163.com
Abstract
Right ventricular thrombus in Mycoplasma pneumoniae pneumonia (MPP)
patient is rare. Herein we reported 5 cases of right ventricular
thrombus. All of them were diagnosed of severe mycoplasma pneumonia,
with increased D-dimer. There was no abnormality in the atrial and
ventricular diameters with a normal cardiac function during the course
of the illness. Every thrombus was closely attached to the tricuspid
chordae. Except one thrombus surgically removed, the remaining thrombi
dissolved during the follow-ups.
key words: Mycoplasma pneumoniae pneumonia, echocardiography,
ventricular thrombus
INTRODUCTION
Mycoplasma pneumoniae (MP) is a common pathogen of community-acquired
pneumonia (CAP) in children[1]. In recent years,
the incidence rate of Mycoplasma pneumoniae pneumonia (MPP) has been
increasing, suggesting an epidemic trend.
Severe cases and those cases refractory to treatments have
increased[2,3]. In addition to pulmonary
inflammation, some children with refractory MPP may have two or more
non- pulmonary complications. In recent years, MPP complications with
lower extremity thrombosis have been reported[4].
There is only three cases of right ventricular thrombosis reported in
literature [5-6]. Our current study reports 5
cases of severe mycoplasma pneumonia complicated with right ventricular
thrombosis diagnosed in our hospital. It further analyzes the
characteristics of echocardiography in detail. We hope this report will
be helpful in the future recognition and diagnosis of right ventricular
thrombus in MMP.
CASE PRESENTATIONS: All these cases were male, age of 6-9 years,
hospitalized in our hospital from January 2016 to December 2019. Their
initial diagnoses were mycoplasma pneumonia, later developed a
complication of right ventricular thrombosis. Their initial symptom was
fever, 39.5-40.5℃, with dry cough. Three of the 5 cases were found
locally to have right ventricular space occupying lesions and came to
our hospital for further diagnosis and treatment. In the remaining 2
cases, the ventricular space occupying lesions were first found during
hospitalization in our hospital. The patients provided informed consent
for the publication of this report.
The general information of all patients is shown in Table 1. Their serum
cold agglutination test results were elevated to ≥ 1:320. D-dimer was
significantly elevated, 4.03-9.06 mg/L (normal 0-0.24 mg/L). Chest CTs
showed variable degrees of pulmonary infiltration and pleural effusion.
All the cardiac space occupying lesions were first detected by
echocardiography. (Figure 1-4) (video 1-2)
Table 1 general date of each case