# Jaundice in a Returning Traveler—A Rare Manifestation of Mycoplasma pneumoniae Infection: Case Report

## TL;DR

A rare case of jaundice caused by a Mycoplasma pneumoniae infection highlights the importance of considering infectious causes in patients with unexplained hemolysis.

## Contribution

This case report adds to the understanding of rare complications of Mycoplasma pneumoniae infections, specifically cold agglutinin hemolytic anemia.

## Key findings

- A 62-year-old man developed jaundice and hemolysis linked to Mycoplasma pneumoniae confirmed by PCR.
- The patient improved after receiving an uncrossmatched blood transfusion and doxycycline treatment.
- The case emphasizes the need for early diagnosis and awareness of macrolide resistance in M. pneumoniae infections.

## Abstract

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.

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 polymerase chain reaction, confirming the diagnosis. He required uncrossmatched blood transfusion and was treated with doxycycline, with clinical improvement over four days.

This case underscores the need for emergency physicians to recognize M pneumoniae-induced hemolysis during periods of increased incidence and seasonal activity. Early diagnosis, targeted testing, and awareness of macrolide resistance are critical for timely intervention and improved outcomes.