Case Report Unusual Initial Presentation of Atypical Pneumonia in a Young Immunocompetent Patient

Mycoplasma pneumoniae is a well-known cause of community-acquired respiratory tract infection, specifically in the childhood population, and represents approximately 15% of all community-acquired pneumonia cases. Mycoplasma pneumoniae is also known for its extrapulmonary manifestations, with cardiovascular presentation being one of the most common. Gastrointestinal manifestations of the disease have been described as well, and evidence stipulates that it could be the first presentation of a M. pneumoniae infection. In our case, a cholestatic pattern was documented initially prior to pulmonary manifestations. Reviewed literature described this presentation as a possible early presentation in patients, but predominant in the pediatric population. Evidence-based data reveal that there is only 1 case reported in the adult population with above gastrointestinal manifestation.