Ayaka Tashiro¹, Raiki Tokutsu¹, Youichi Yanagawa^1,

A 58-year-old male with a history of smoking presented to a local hospital with cough and dyspnea for one week. He was transferred to our hospital due to decreased right lung transparency and impaired oxygenation. Upon arrival, his PaO2/FiO2 ratio was approximately 70, necessitating intubation and mechanical ventilation. Levofloxacin was initiated due to a positive Mycoplasma antigen test. After admission to the intensive care unit, steroid pulse therapy was also initiated. However, oxygenation and ventilation deteriorated further. It was determined that mechanical ventilation alone could not sustain life, leading to the initiation of venovenous extracorporeal membrane oxygenation (VV-ECMO) on the second day of hospitalization. Subsequently, oxygenation and ventilation showed a trend of improvement. Due to bleeding from the cannula insertion site, the ECMO was weaned off on the fifth day. Respiratory status subsequently stabilized, leading to extubation on the seventh day of illness. Oxygen requirements ceased, and the patient was discharged home walking unaided on the thirty-third day of illness. This case demonstrates the value of using ECMO when indications are met and it is determined that mechanical ventilation alone is unlikely to sustain life in severe Mycoplasma pneumonia.

mycoplasma pneumonia, ECMO, steroid