Humans ; Mycoplasma pneumoniae ; Pneumonia, Mycoplasma ; complications ; Pulmonary Embolism ; complications

OBJECTIVETo study the clinical features and diagnostic methods of mycoplasma pneumonia complicated with cerebral infarction.

METHODData of 3 children with mycoplasma pneumonia who developed cerebral infarction, including clinical manifestations and imaging were collected, analyzed and the literature was reviewed.

RESULTAll the cases were pre-school or school-aged children, who developed the respiratory infection initially, the neurological symptoms were acute hemiparesis, with or without convulsion. The IgM antibody to Mycoplasma pneumoniae (Mp) was positive. Pulmonary imaging showed unilateral consolidation with atelectasis and pleural exudate. Neuroimaging showed occlusion of middle cerebral artery and infarction of its territory. After giving azithromycin, anti-coagulative and thrombolytic treatments, the neurological deficits recovered to some extent.

CONCLUSIONMycoplasma pneumonia were diagnosed based on respiratory symptoms and pulmonary imaging, the accompanied cerebral infarction was confirmed by neurological and neuroimaging findings.

Cerebral Infarction ; complications ; microbiology ; Child ; Child, Preschool ; Female ; Humans ; Male ; Mycoplasma pneumoniae ; Pneumonia, Mycoplasma ; complications

Humans ; Lung ; physiopathology ; Pneumonia, Mycoplasma ; complications ; diagnosis ; physiopathology ; therapy

OBJECTIVE: To study the clinical features of children with METHODS: A total of 310 MPP children who were hospitalized and underwent bronchoalveolar lavage from June 2018 to June 2019 were enrolled and divided into two groups: simple MPP group with 241 children (without peripheral lymphocytopenia) and MPP + peripheral lymphocytopenia group with 69 children. The two groups were compared in terms of clinical data and treatment outcome. RESULTS: Compared with the simple MPP group, the MPP + peripheral lymphocytopenia group had significantly longer duration of fever and length of hospital stay and significant increases in C-reactive protein, lactate dehydrogenase, and CONCLUSIONS Children with MPP and peripheral lymphocytopenia tend to have more severe immunologic injury. Peripheral blood lymphocyte count may be used to evaluate the severity of MPP.
Bronchoalveolar Lavage Fluid ; Child ; Humans ; Lymphopenia/etiology* ; Mycoplasma pneumoniae ; Pneumonia, Mycoplasma/complications* ; Retrospective Studies

Objective: To investigate the predictive factors for bronchitis obliterans in refractory Mycoplasma pneumoniae pneumonia (RMPP). Methods: A restrospective case summary was conducted 230 patients with RMPP admitted to the Department of No.2 Respiratory Medicine of Beijing Children's Hospital, Capital Medical University from January 2013 to June 2017 were recruited. Clinical data, laboratory results, imaging results and follow-up data were collected. Based on bronchoscopy and imaging findings 1 year after discharge, all patients were divided into two groups: one group had sequelae of bronchitis obliterans (sequelae group) and the other group had not bronchitis obliterans (control group), independent sample t-test and nonparametric test were used to compare the differences in clinical features between the two groups. Receiver operating characteristic (ROC) curve to explore the predictive value of Bronchitis Obliterans in RMPP. Results: Among 230 RMPP children, there were 115 males and 115 females, 95 cases had sequelae group, the age of disease onset was (7.1±2.8) years;135 cases had control group, the age of disease onset was (6.8±2.7) years. The duration of fever, C-reative protein (CRP) and lactate dehydrogenase (LDH) levels, the proportion of ≥2/3 lobe consolidation, pleural effusion and the proportion of airway mucus plug and mucosal necrosis were longer or higher in the sequelae group than those in the control group ((17±9) vs. (12±3) d, (193±59) vs. (98±42) mg/L,730 (660, 814) vs. 486 (452, 522) U/L, 89 cases (93.7%) vs. 73 cases (54.1%), 73 cases (76.8%) vs.59 cases (43.7%), 81 cases (85.3%) vs. 20 cases (14.8%), 67 cases (70.5%) vs. 9 cases (6.7%), t=5.76, 13.35, Z=-6.41, χ²=14.64, 25.04, 22.85, 102.78, all P<0.001). Multivariate Logistic regression analysis showed that the duration of fever ≥10 days (OR=1.200, 95%CI 1.014-1.419), CRP levels increased (OR=1.033, 95%CI 1.022-1.044) and LDH levels increased (OR=1.001, 95%CI 1.000-1.003) were the risk factors for sequelae of bronchitis obliterans in RMPP. ROC curve analysis showed that CRP 137 mg/L had a sensitivity of 82.1% and a specificity of 80.1%; LDH 471 U/L had a sensitivity of 62.7% and a specificity of 60.3% for predicting the development of bronchitis obliterans. Conclusions: The long duration of fever (≥10 d), CRP increase (≥137 mg/L) may be used to predict the occurrence of sequelae of bronchitis obliterans in RMPP. It is helpful for early recognition of risk children.
Child ; Male ; Female ; Humans ; Child, Preschool ; Mycoplasma pneumoniae ; Retrospective Studies ; Pneumonia, Mycoplasma/complications* ; Disease Progression ; L-Lactate Dehydrogenase ; Fever

Female ; Humans ; Infectious Mononucleosis ; drug therapy ; etiology ; Male ; Pneumonia, Mycoplasma ; complications

OBJECTIVETo study the association between wheezing and Mycoplasma pneumoniae (MP) infection in infants and young children.

METHODSA total of 228 hospitalized infants and young children who were diagnosed with lower respiratory tract infection were enrolled and classified into initial wheezing group (n=65), recurrent wheezing group (n=83), and non-wheezing group (n=80). Fasting serum was collected on the day or the second day of admission. ELISA was used to measure MP-IgM, chemiluminescence was used to measure serum total immunoglobulin E (TIgE), and EUROLine was used to measure the common serum allergen specific immunoglobulin E (sIgE). The data on the manifestations of atopic constitution and the family history of allergic diseases were collected.

RESULTSThe initial wheezing group and the recurrent wheezing group showed significantly higher positive MP infection rate and serum TIgE level than the non-wheezing group (P<0.05). The recurrent wheezing group showed a significantly higher positive rate of sIgE than the initial wheezing group and the non-wheezing group (P<0.05), and in these patients, the manifestations of atopic constitution and the family history of allergic diseases were closed associated with the pathogenesis of wheezing.

CONCLUSIONSMP infection is closely associated with wheezing in infants and young children. MP is one of the most common pathogens for wheezing in infants and young children, and the allergen sIgE, atopic constitution, and a family history of allergic diseases are important risk factors for recurrent wheezing.

Child, Preschool ; Female ; Humans ; Immunoglobulin E ; blood ; Infant ; Male ; Pneumonia, Mycoplasma ; complications ; Recurrence ; Respiratory Sounds ; etiology

OBJECTIVETo study the clinical characteristics of Mycoplasma pneumoniae (MP)-associated ischemic stroke in children.

METHODSThe case of a girl with MP-associated ischemic stroke was reported, including clinical manifestations and laboratory and imaging examinations, and related literature was reviewed.

RESULTSThe girl, who was suffering from a respiratory tract infection was found to have hemiplegia and aphasia which were expressed in ischemic stroke. IgM antibody to MP in serum (1∶320) and lavage fluid was positive. Pulmonary imaging showed unilateral consolidation and pleural exudate. Cerebral neuroimaging examination showed occlusion of the bilateral middle cerebral artery, mainly on the left side. The neurological symptoms and signs were recovered after comprehensive therapy with medication (azithromycin, hormone and heparin) and rehabilitation training.

CONCLUSIONSIschemic stroke is rare but severe manifestation of central nervous system damage in children suffering from MP infection. Cerebral imaging and etiological examinations contribute to the diagnosis. Early use of macrolide antibiotics, anticoagulant and hormone may improve the prognosis.

Brain Ischemia ; etiology ; Child ; Female ; Humans ; Pneumonia, Mycoplasma ; complications ; drug therapy ; Stroke ; etiology

OBJECTIVETo explore the essential points for diagnosis of pulmonary embolism in children with mycoplasma pneumonia.

METHODRetrospective analysis of the clinical and laboratory data of a pediatric case who developed pulmonary embolism after mycoplasma pneumonia was performed for the key points for diagnosis.

RESULTA-six-year old boy was admitted with chief complaint of fever and cough for half a month, combined with chest pain and mild labored breath. Vital signs were stable. Breathing movement of the left side weakened and there was left lower lobe percussion dullness. Breath sound was found weakened in the left lung, and a few fine crackles were audible. The results of laboratory tests were as follows: mycoplasma antibody (IgM) 1:128, cold agglutinin test 1:1024, blood D dimer 14.81 mg/L; anticardiolipin antibody was positive; plasma protein C activity was 60% (normal range 70% - 130%). Pulmonary artery computed tomographic angiography revealed a mass opaque shadow in left lower lobe, the branch of left lower bronchial artery was partially obstructed. Echocardiography showed tricuspid valve mild regurgitation, estimated pulmonary pressure was 5.1 kPa. Single-photon emission computed tomography indicated that radioactivity distribution was apparently sparse in the dorsal segment, anterior basal segment, outer basal segment and inferior lingular segment of the left lung. The preliminary diagnosis on admission was mycoplasma pneumonia with pleural effusion, pulmonary embolism. Intravenous erythromycin combined with meropenem were administered. Anticoagulation therapy was initiated with low molecular weight heparin and then oral warfarin tablets. Pleural effusion disappeared soon, D dimer descended to 0.38 mg/L, and pulmonary artery pressure declined. After 3-month follow-up, anti-cardiolipin antibody was negative, plasma protein C activity recovered, and lung lesions were absorbed.

CONCLUSIONWhen mycoplasma pneumonia is accompanied by chest pain or dyspnea and there are bloody pleural effusion, pulmonary hypertension, positive antiphospholipid antibody and elevated D dimer, pulmonary embolism should be considered. Diagnosis could be clarified by the result of pulmonary artery computed tomographic angiography.

Antibodies, Antiphospholipid ; blood ; Child ; Fibrin Fibrinogen Degradation Products ; metabolism ; Humans ; Male ; Mycoplasma pneumoniae ; Pneumonia, Mycoplasma ; complications ; diagnosis ; Pulmonary Embolism ; complications ; diagnosis ; Retrospective Studies

We report a case of acute severe hepatitis with Mycoplasma pneumoniae (M. pneumoniae) infection and transient depression of multiple coagulation factors. A 5-year-old boy, previously healthy, was admitted with pneumonia. M. pneumoniae infection was confirmed by serology testing. Liver enzymes were elevated on admission without any past medical history. After treatment with azithromycin for 3 days, pneumonia improved, but the hepatitis was acutely aggravated. Partial thromboplastin time (PTT) was prolonged and depression of multiple coagulation factors developed. Liver biopsy revealed features consistent with acute hepatitis. A week later, liver enzymes were nearly normalized spontaneously. Normalization of prolonged PTT and coagulation factors were also observed several months later. This may be the first case of transient depression of multiple coagulation factors associated with M. pneumoniae infection.
Acute Disease ; Blood Coagulation Factors/metabolism ; Child, Preschool ; Hepatitis A/blood/diagnosis/*etiology ; Humans ; Male ; Mycoplasma pneumoniae/pathogenicity ; Partial Thromboplastin Time ; Pneumonia, Mycoplasma/blood/*complications