Clinical analysis of Mycoplasma pneumoniae bronchiolitis in children
10.3760/cma.j.cn101070-20210722-00861
- VernacularTitle:儿童肺炎支原体细支气管炎临床特征分析
- Author:
Kunling HUANG
1
;
Sukun LU
;
Ling SUN
;
Bo NIU
;
Lijie CAO
;
Lili JI
;
Jinfeng SHUAI
;
Jianhua LIU
Author Information
1. 河北省儿童医院呼吸二科，石家庄 050031
- Keywords:
Child;
Mycoplasma pneumoniae;
Bronchiolitis;
Clinical features
- From:
Chinese Journal of Applied Clinical Pediatrics
2022;37(12):909-913
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics of Mycoplasma pneumoniae (MP) bronchiolitis to provide references for clinical prevention and treatment.Methods:From January 2019 to January 2020, the clinical data of children diagnosed with MP bronchiolitis in the Department of Respiratory 2 of Hebei Children′s Hospital were retrospectively collected and analyzed, and the patients were followed up to observe the prognosis.Results:Among the 67 children, there were 39 boys and 28 girls, with age of 5 (1-14) years.All the children had cough, 63 cases (94.0%) had fever, 49 cases (77.8%) had high fever (≥39.0 ℃), and the median total fever course was 8(1-27) d; 10 cases (14.9%) had wheezing; 5 cases (7.5%) had dyspnea; 3 cases (4.5%) had hypoxemia; wet rales were heard in 58 cases (86.6%) and wheezing in 10 cases (14.9%). Forty-eight patients (71.6%) had family allergy history or personal allergy history.The average value of peripheral blood white blood cells was (8.6±2.6)×10 9/L; the me-dian of C reactive protein was 9.1(0.5-55.6) mg/L, of which 7 cases (10.4%) were ≥30 mg/L; the median of lactate dehydrogenase was 278(181-590) U/L.Tree bud sign and central lobular nodules were the main findings of high-resolution CT of the chest.Among them, 45 cases (67.2%) had bilateral lesions, 38 cases (56.7%) involved ≥3 lung lobes, and 22 cases (32.8%) had a little lung consolidation, 19 cases (28.4%) had a small amount of pleural effusion.The bronchoscopic features of 35 children (52.2%): 71.4%(25/35 cases) showed white flocculent and cord-like secretions, 17.1%(6/35 cases) displayed mucus plugs blocking the lumen, and 10.9%(4/35 cases) showed no-dular protrusions and granulation tissue hyperplasia.All children were treated with Azithromycin sequentially; 42 children (62.7%) were treated with low-dose hormones, and the average initiation time was on day (10.62±2.71) and the median course was 14(2-42) d. Sixty-seven cases were followed up for half a year, of which 61 cases (91.0%) had almost complete lung recovery, and 6 cases (9.0%) developed bronchiolitis obliterans (BO). Conclusions:MP bronchiolitis mostly occurs in infants and preschool children with a family history of allergies or personal allergies.Fever and cough are the main clinical manifestations.In severe cases, dyspnea and hypoxemia may occur.The physical signs of the lungs are mainly include wet rales, some of which are wheezing.White flocculent and cord-like secretions are the main manifestations of bronchoscopy.After active treatment, most children have a good prognosis, and some children may develop BO.
