Cold agglutinin syndrome with severe haemolytic anaemia in a patient diagnosed of disseminated tuberculosis and concomitant Mycoplasma pneumoniae infection

摘要

It has been frequently observed that tuberculosis patients, especially disseminated cases, have minor degrees of anaemia (Cameron, 1974). But severe haemolytic episodes are rarely documented. We describe an episode of severe immune haemolytic anaemia due to cold agglutinin syndrome in a young woman with disseminated tuberculosis and concomitant Mycoplasma pneumoniae infection. A 24-year-old woman presented to the emergency department of our hospital in October 2010 with a 10-day history of continuous fever around 39-40 degC and non-productive cough. She had taken a 3-day course of intravenous azithromycin and another 3-day course of combined intravenous azithromycin and cefoperazone in local health facility but shown no improvement.