Clinical and radiologic manifestations of Mycoplasma pneumoniae infection in children

Turk J Pediatr. 2022;64(6):1031-1040. doi: 10.24953/turkjped.2022.545.

Abstract

Background: Mycoplasma pneumoniae (MP) is one of the most important etiological agents of communityacquired pneumonia in children.

Methods: The medical records of children with an MP infection between 2008 and 2015 were reviewed for their clinical, laboratory radiological features.

Results: This study included 244 patients (male 57.4%) with a median age of 80.5 months (IQR, 46.5-120 months). A total of 78 (32%) patients were < 5 years old, and 166 (68%) were ≥ 5 years old. The most common complaints before admission to the hospital were cough (84.8%), fever (57.4%), and weakness (18.9%). In the < 5 years old age group, oxygen saturation was lower, and tachypnea was more common than in the ≥ 5 years old age group (p=0.02 and p=0.05, respectively). Similarly, the physical findings such as the prolonged expiration, presence of retractions, and rhonchi were more frequent in the < 5 years old age group (p=0.001, p=0.000, p=0.02, respectively). Extrapulmonary manifestations were present in 45 (18.4%) patients, and skin involvement was the most common one (7.7%). Two hundred-thirty-eight (97.5%) patients had chest radiographs, and 45 (18.4%) had normal radiography. The most common radiological involvement was peribronchial infiltration (n=70, 28.7%). Of the patients, 147 (60.2%) were hospitalized, and 97 (39.7%) were followed up as outpatients. It was determined that 156 (63.9%) patients had commenced macrolide empirically, and 61 (25%) patients were treated with positive serology results.

Conclusions: The prolonged fever, cough and expiration time, wheezing and rhonchi in younger children, and segmental-lober consolidation in chest radiography could be clues for MP infection. Further studies in different age groups can facilitate an understanding of MP infection`s epidemic characteristics and clinical features that will provide early diagnosis and appropriate treatment.

Keywords: Mycoplasma pneumoniae; children; infection; radiograph.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Child, Preschool
  • Cough / drug therapy
  • Cough / etiology
  • Fever / etiology
  • Humans
  • Male
  • Mycoplasma pneumoniae
  • Pneumonia, Mycoplasma* / diagnostic imaging
  • Pneumonia, Mycoplasma* / epidemiology
  • Respiratory Sounds

Substances

  • Anti-Bacterial Agents