Risoluzione di infiltrati polmonari migranti in un paziente con infezione da Mycoplasma pneumoniae e Bordetella pertussis a seguito di terapia con moxifloxacina

A 37-year-old Japanese woman, who was not vaccinated against Bordetella pertussis, developed a nocturnal fever with persistent dry cough for more than 2 weeks. A chest radiograph showed poorlydefined nodular opacities in the left lung. Due to the significant rise in serum antibodies for both Mycoplasma pneumoniae and B. pertussis, a diagnosis of dual infection with the organisms was made. Despite the use of susceptible antibiotics, the patient's symptoms did not improve and her chest radiograph showed migratory pulmonary infiltrates. However, a quinolone derivative, moxifloxacin, dramatically improved her symptoms and resolved the pulmonary infiltrates shortly after administration. In this case, due to the lymphocyte- stimulatory nature of M. pneumoniae and B. pertussis, an increased immunological response was likely to be involved in the pathogenesis of pneumonia. The immunomodulatory property of moxifloxacin was thought to repress the increased lymphocyte activity, and thus facilitated complete remission of the disease.