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[Clinical characteristics of refractory Mycoplasma pneumoniae pneumonia in children]
1Department of Infection Control, Shanghai Children's Hospital/Shanghai Jiao Tong University, Shanghai 200062, China. shulinhua@126.com.
Objective:
To provide a basis for early diagnosis and treatment of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children by comparing the clinical characteristics of RMPP and general Mycoplasma pneumoniae pneumonia (MPP).
Methods:
Children with MPP hospitalized between October 2015 and December 2016 were selected as study subjects. According to the diagnostic criteria, children were divided into RMPP group (n=152) and MPP group (n=551). The differences between the two groups in the basic situation, clinical manifestations, infection parameters and myocardial enzymes were compared.
Results:
There were no significant differences in gender and age between the RMPP and MPP groups (P>0.05). The peak temperature in the RMPP group was significantly higher than that in the MPP group on the first day of admission (P<0.01). The percentage of children with augmentation in the RMPP group was lower than that in the MPP group (P=0.009). The percentage of neutrophils [Ne(%)] and serum procalcitonin (PCT) levels in the RMPP group were both higher than those in the MPP group (P<0.05), while the percentage of lymphocytes was significantly lower in the RMPP group (P<0.05). The serum levels of aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) in the RMPP group were also higher than those in the MPP group (P<0.05). Binary logistic regression analysis showed that the peak temperature and LDH were closely related to RMPP in children (P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of the peak temperature and LDH for the diagnosis of RMPP was 0.647 and 0.637 respectively. In children ≤2 years old, when the threshold value of LDH was 400 U/L, the diagnostic sensitivity was 52.63% and the specificity was 54.84%. In children above 2 years old, when the threshold value of LDH was 335 U/L, the diagnostic sensitivity was 69.92% and the specificity was 51.55%.
Conclusions:
The children with RMPP have a high fever in the early stage. Meanwhile there are abnormal laboratory test results in these children. Elevated serum LDH levels have a high clinical value of early diagnosis of RMPP, especially in children above 2 years.
Insights
Refractory Mycoplasma pneumoniae pneumonia (RMPP) in children presents with early high fever and abnormal lab results. Elevated lactate dehydrogenase (LDH) levels are valuable for early RMPP diagnosis, particularly in children over two years old.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Clinical Diagnostics
Background:
- Mycoplasma pneumoniae pneumonia (MPP) is a common childhood respiratory infection.
- Refractory MPP (RMPP) presents unique diagnostic and treatment challenges.
- Early identification of RMPP is crucial for timely intervention.
Purpose of the Study:
- To compare clinical characteristics of RMPP and general MPP in children.
- To identify key indicators for early diagnosis of RMPP.
- To establish a basis for improved RMPP management.
Main Methods:
- Retrospective analysis of hospitalized children with MPP (October 2015 - December 2016).
- Division into RMPP (n=152) and MPP (n=551) groups based on diagnostic criteria.
- Comparison of clinical manifestations, infection parameters, and myocardial enzymes.
Main Results:
- RMPP group showed significantly higher peak temperatures and elevated neutrophils, procalcitonin (PCT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) levels.
- Lymphocyte percentage was significantly lower in the RMPP group.
- Peak temperature and LDH were identified as significant predictors for RMPP via logistic regression.
Conclusions:
- Children with RMPP exhibit early high fever and distinct laboratory abnormalities.
- Elevated serum LDH levels demonstrate significant clinical value for early RMPP diagnosis.
- LDH shows particular diagnostic utility in children over two years of age.
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