Dramatic response to high dose steroids in refractory and severe Mycoplasma pneumonia

M. pneumoniae infection usually causes self-limiting disease. Rarely it can lead to severe life-threatening pneumonia or refractory infection. Excessive cell mediated immune response to infection thought to be the mechanism of refractory and severe mycoplasma pneumonia. IL-8 is thought to play a part in severe and refractory mycoplasma infections. Furthermore, serum LDH has shown to be a marker of severe and refractory disease. However, the relationship and the mechanism of raised LDH and IL-18 are not clearly explained in the literature. There were several case studies showing benefit of steroids among children with severe and refractory mycoplasma pneumonia. We report a case of a young man who developed severe and refractory mycoplasma pneumonia who showed a dramatic response to steroids.