Intravascular Coagulation and Mycoplasma Pneumoniae Infection

To The Editors: Chiou et al. 1 report a case of Mycoplasma pneumoniae infection complicated with disseminated intravascular coagulation. Although this clotting disorder has been reported during M. pneumoniae infection in few cases,2, 3 the pathogenic mechanisms is obscure as correctly stated by Chiou et al. In experimental studies we have shown4, 5 that lipoglycans from some Mycoplasma species (including M. pneumoniae) can induce the generation of procoagulant activity (tissue factor-like ability) by human mononuclear cells in vitro. Because this activity is a potent trigger of blood coagulation, our results suggest a possible mechanism for the clotting abnormalities (e.g. disseminated intravascular coagulation) that complicate severe M. pneumoniae infections. Obviously additional investigations concerning other virulence factors, bacterial products and mediators might define the possible contributors to pathogenic mechanisms of the variable severity, clinical presentations and systemic disorders associated with the disease. Donato Fumarola, M.D. Institute of Medical Microbiology; Bari University School of Medicine; Bari, Italy