A case of Mycoplasma pneumonia as initial symptom of polyarthralgia with heart murmur

A 53-year-old woman was admitted to our hospital with pyrexia and Polyarthralgie. Chest X-ray showed infilitration at the bilateral lower lung field. The patient had polyarthralgia, left chest pain and pansystolic heart murmur(Levine III). As the anti-Mycoplasma antibody was ¬positive, the therapy of moxifloxacin was started for Mycoplasma pneumonia. Afterwards, arthralgia worsened and we suspected drug-induced arthralgia, so we changed the medication to azithromycin. However, shadows on chest X-ray and arthralgia were not improved. Chest pain and pleural effusions were worsening. After changing the medication again to minocycline and pazufloxacin, pneumonia was improved and she was discharged.