Introduction: Cold agglutinin hemolytic anemia is a rare but serious complication of infections, including Mycoplasma pneumoniae. This case highlights the importance of considering infectious causes in patients with unexplained hemolysis.
\nCase Report: A 62-year-old previously healthy male developed jaundice, dyspnea, and fatigue three weeks after returning from South America. Labs showed hemolysis with agglutination, a positive direct Coombs test, and elevated cold agglutinin titers. M. pneumoniae was identified via PCR (polymerase chain reaction), confirming the diagnosis. He required uncrossmatched blood transfusion and was treated with doxycycline, with clinical improvement over four days.
\nConclusion: This case underscores the need for emergency physicians to recognize M. pneumoniae-induced hemolysis in returning travelers. Early diagnosis, targeted testing, and awareness of macrolide resistance are critical for timely intervention and improved outcomes.
","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"hemolytic anemia"},{"word":"cold agglutinin disease"},{"word":"Mycoplasma pneumoniae"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3300t7bj","frozenauthors":[{"first_name":"Andrea","middle_name":"","last_name":"Molin","name_suffix":"","institution":"Lewis Katz School of Medicine at Temple University, Department of Infectious Diseases, Philadelphia, Pennsylvania","department":""},{"first_name":"Molly","middle_name":"","last_name":"Crowe","name_suffix":"","institution":"Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania","department":""},{"first_name":"Brionna","middle_name":"","last_name":"Matt","name_suffix":"","institution":"Lewis Katz School of Medicine at Temple University, Department of Infectious Diseases, Philadelphia, Pennsylvania","department":""},{"first_name":"Jessica","middle_name":"Ray","last_name":"Jackson","name_suffix":"","institution":"Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania","department":""}],"date_submitted":"2025-04-03T03:39:32.485000+06:00","date_accepted":"2025-06-16T02:32:33.066000+06:00","date_published":"2025-08-27T11:40:00+06:00","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/47139/galley/40146/download/"}]}