Objectives. Priapism in the pediatric population is rare and most commonly occurs secondary to sickle cell disease or hematologic malignancy. We present a case of a 12-year-old boy with priapism who required aggressive surgical therapy for adequate detumescence. This patient had a recent viral upper respiratory infection and titers for Mycoplasma pneumoniae were indicative of infection. We propose that a hypercoagulable state was induced by the M. pneumoniae infection, which resulted in the priapism.

Methods. A 12-year-old boy with a recent upper respiratory illness presented to his pediatrician with priapism. After failing conservative management, the patient ultimately required a surgical shunt for detumescence. Serum was sent to detect antibodies against M. pneumoniae.

Results. The child failed to respond to corporeal irrigations and bilateral Winter shunts. He underwent an El-Ghorab procedure the following morning, which resulted in a flaccid penis. Serum M. pneumoniae antibodies were detected and indicated moderate infection.

Conclusions. We propose that this 12-year-old boy had priapism secondary to infection with M. pneumoniae. M. pneumoniae infection can produce a hypercoagulable state, especially in selected areas of the circulation. This is the first reported case of priapism associated with M. pneumoniae.