Clinical manifestations in infants and children with Mycoplasma pneumoniae infection

PLoS One. 2018 Apr 26;13(4):e0195288. doi: 10.1371/journal.pone.0195288. eCollection 2018.

Abstract

Background: Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in older children. Pulmonary and extra-pulmonary symptoms associated with M. pneumoniae infection are reported. M. pneumoniae is mainly epidemic in Denmark with the recurrence every 4-7th year.

Aims: Retrospectively, to describe the epidemiology and clinical features, in infants and children, during the M. pneumoniae epidemic in 2010 and 2011.

Methods: All children under the age of 16 that were tested for M. pneumoniae during the period 01.02.2010-31.01.2012 were included. Medical charts, as well as radiological findings, were reviewed for all children with M. pneumoniae. A post-hoc analysis of viral co-infections was done on part of the cohort.

Results: 134 of 746 children were tested positive for M. pneumoniae by PCR or serology. Positive tests were found in 65% of children seven years and older, in 30% of 2-6-year-olds and 4% of infants (less than two years of age). Viral co-infection was found in 27% of the tested samples. The clinical presentation was a cough, asthma-like symptoms and low-grade fever. Extra-pulmonary symptoms were common and presented as nausea/vomiting by 33% of the children and skin manifestations by 25%. 84% of the children had a chest x-ray taken, and there were positive radiological findings in 94% of these.

Conclusion: M. pneumoniae also affected infants and young children and symptoms were similar to infections with respiratory viruses, but severe LRTI were also seen. During an up-coming epidemic, assessment of extra-pulmonary manifestations can be helpful when diagnosing M. pneumoniae infections.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Coinfection
  • Denmark
  • Endemic Diseases
  • Female
  • Humans
  • Infant
  • Male
  • Mycoplasma pneumoniae*
  • Pneumonia, Mycoplasma / diagnostic imaging
  • Pneumonia, Mycoplasma / epidemiology*
  • Pneumonia, Mycoplasma / physiopathology*
  • Retrospective Studies

Grants and funding

The involved departments (Department of Paediatrics, Nordsjællands Hospital, Hillerød, Denmark and Department of Clinical Microbiology, Herlev Hospital, Herlev, Denmark) sponsored this study by financing the microbiological analyses that was done supplementary to the clinical workups and by salaries to MJS, MBF, DSH, and IMJ. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.