Acute pancreatitis and hepatitis in an 11-year-old boy following Mycoplasma pneumoniae infection: case report

Mycoplasma pneumoniae infection is a common cause of respiratory illness in children, but extrapulmonary involvement is uncommon and may present diagnostic challenges. Among these manifestations, hepatic injury and acute pancreatitis are rarely reported in pediatric patients. We describe the case of an 11-year-old boy who developed recurrent fever and abdominal pain after initial improvement from M. pneumoniae pneumonia. On admission, he exhibited markedly elevated aspartate aminotransferase and alanine aminotransferase levels, along with significant increases in amylase and lipase. Abdominal ultrasonography demonstrated mild pancreatic swelling and thickening of the gallbladder and common bile duct walls, consistent with acute pancreatitis and associated hepatobiliary inflammation. The patient was treated with nil per os, intravenous hydration, analgesics, proton pump inhibitors, and continued azithromycin therapy. His abdominal pain gradually improved, and liver and pancreatic enzyme levels normalized over the course of hospitalization. He was discharged after 6 days, and follow-up ultrasonography confirmed complete resolution of pancreatobiliary abnormalities. This case underscores the importance of considering acute pancreatitis when abdominal pain and elevated liver enzymes develop during the course of M. pneumoniae infection, even in patients with improving respiratory symptoms. Early recognition and supportive management can help prevent complications and ensure favorable outcomes.