Surgical treatment intracardiac thrombosis and pulmonary embolism complication of Mycoplasma pneumoniae pneumonia: a case report

Mycoplasma pneumoniae pneumonia (MPP) is a common community-acquired pneumonia in children, which can uncommonly lead to intracardiac thrombosis. Previous studies have suggested that anticoagulant therapy and thrombolytic therapy were the main treatment options. We report the case of a 7-year-old boy with MPP complicated by intracardiac thrombosis and pulmonary embolism. The patient presented with persistent fever, chest pain, and elevated D-dimer levels. The computed tomography angiography (CTA) and echocardiography revealed a thrombus extension from the right inferior pulmonary vein to the left atrium. Considering the risk of thrombus detachment, surgical thrombectomy was performed under cardiopulmonary bypass. Two months follow-up revealed no evidence of new thrombus formation and D-dimer levels normalized. In cases of MPP complicated by intracardiac thrombus formation, particularly involving the left heart chambers, surgical thrombectomy may be a viable treatment option. D-dimer served as an important biomarker for both the early detection of thrombosis and the monitoring of treatment efficacy.