A 17-year-old woman presented with cough and fever. Treatment with cefteram pivoxil and fosfomycin calcium was not effective. Chest radiography showed infiltration with an air bronchogram in the left upper lung field. The case was initially treated as atypical pneumonia by administering minocycline hydrochloride and piperacillin sodium. Since acute renal failure progressed rapidly, we introduced hemodialysis, and renal function improved. The mycoplasma polymerase chain reaction (PCR) in the pharynx smear was positive, and the mycoplasma serum titer was 1280 on admission. On the basis of these findings, mycoplasma pneumonia was diagnosed. Only one other case of mycoplasma pneumonia with hemodialysis has been reported in Japan. We report and assess the pathogenesis of mycoplasma pneumonia complicated by renal dysfunction.
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