Mycoplasma-associated Cold Agglutinin-induced Red Blood Cell and Neutrophil Agglutination: A Typical Hematological Finding of Atypical Pneumonia

Abstract: Mycoplasma pneumonia is an atypical pneumonia that has been linked to a variety of extrapulmonary consequences, including autoimmune hemolytic anemia and agglutination caused by cold agglutinin production. Early diagnosis of M . pneumoniae was made possible by identifying extrapulmonary symptoms. A 6-year-old kid was brought in by his parents after complaining of fever, cough, and runny nose for a week and difficulty in breathing for 2 days. The initial hemogram reveals mild anemia with unusual red blood cells (RBCs), histogram flags, RBC counts, and RBC indices. Peripheral blood films revealed RBCs and neutrophils agglutination, prompting us to investigate cold agglutinin hemolytic anemia due to Mycoplasma . Further immunohematological, serological, and molecular examinations supported the diagnosis of M . pneumoniae , which was successfully treated with macrolide medicines. The present case highlighted the importance of early detection of cold agglutinin-mediated histogram disparities and agglutination in Mycoplasma infection for accurate diagnosis, treatment, and better patient outcomes.