SARS-CoV-2 Infection is a frequent cause of pulmonary failure in 2020, but not the only one – a case report

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Abstract Background In 2020, a novel coronavirus caused a global pandemic with a clinical picture termed COVID-19 accounting for numerous cases of ARDS. However, there are still other infectious causes of ARDS that should be considered, especially, as the majority of these pathogens are specifically treatable. Case Presentation We present the case of a 36-year-old gentleman who was admitted to the hospital with flu-like symptoms after completing a half-marathon one week before admission. As infection with SARS-CoV2 was suspected based on radiologic imaging, the hypoxemic patient was immediately transferred to the ICU, where he developed ARDS. Empiric antimicrobial chemotherapy was initiated, the patient deteriorated further, therapy was changed and the patient was transferred to a tertiary care ARDS center. As cold agglutinins were present, the hypothesis of an infection with SARS-CoV-2 was then questioned. Bronchoscopic sampling revealed Mycoplasma (M.) pneumoniae. When antimicrobial chemotherapy was adjusted, the patient recovered quickly. Conclusion Usually, M. pneumoniae causes mild disease. When antimicrobial chemotherapy was adjusted, the patient recovered quickly. The case underlines the importance of adhering to established treatment guidelines, scrutinizing treatment modalities and not forgetting other potential causes of severe pneumonia or ARDS.

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