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Pulmonary and Extrapulmonary Manifestations in Hospitalized Children with Mycoplasma Pneumoniae Infection
Carlotta Biagi1, Alessandra Cavallo2, Alessandro Rocca1
1Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant'Orsola Hospital, 40138 Bologna, Italy.
Abstract:
Mycoplasma pneumoniae (MP) is one of the main causes of both upper and lower respiratory infections in school-aged children, accounting for up to 40% of community-acquired pneumonia. Younger children are also affected, and extrapulmonary manifestations have been recently reported in the pediatric population. We carried out a retrospective analysis of MP-positive patients admitted to the Pediatric Emergency Unit of S. Orsola Malpighi University Hospital in Bologna, the largest tertiary pediatric referral center in the Emilia-Romagna region, Northern Italy, between 2012 and 2020. We identified 145 patients with MP infection (82 males and 63 females), 27% of which were younger than 2 years; the median age was 5 years (interquartile range 1-9). The clinical presentation partially differed between age groups. School-aged children were more likely to have a chest X-ray-confirmed pneumonia (p = 0.013), while younger children required oxygen therapy more often (p = 0.048). Seventy-four children (51%) showed extrapulmonary manifestations, mainly gastrointestinal (30%) and dermatological (14%). Neurological symptoms were more frequent in children older than 6 years (p = 0.006). The rate of other extrapulmonary manifestations did not differ significantly between age groups. This study shows that MP infection is a frequent cause of pediatric hospitalization, including of children younger than 2 years. Clinicians should be aware of the variable clinical expressions of MP, including extrapulmonary manifestations, to achieve a correct diagnosis and determine appropriate treatment.
Insights
Mycoplasma pneumoniae (MP) frequently causes respiratory infections and hospitalizations in children, including those under two. This infection presents with diverse symptoms, including extrapulmonary issues, necessitating clinical awareness for accurate diagnosis and treatment.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Clinical Microbiology
Background:
- Mycoplasma pneumoniae (MP) is a significant cause of pediatric respiratory infections, including community-acquired pneumonia.
- Extrapulmonary manifestations of MP infection are increasingly recognized in children.
- Understanding MP's varied clinical presentation is crucial for effective management.
Purpose of the Study:
- To analyze the clinical characteristics and outcomes of Mycoplasma pneumoniae infections in hospitalized pediatric patients.
- To investigate age-related differences in MP presentation and extrapulmonary manifestations.
- To highlight the importance of recognizing diverse MP symptoms for diagnosis.
Main Methods:
- Retrospective analysis of 145 MP-positive pediatric patients admitted between 2012-2020.
- Data collection included patient demographics, clinical presentation, and diagnostic findings.
- Comparison of clinical features between different age groups.
Main Results:
- MP infection commonly affects children, with 27% younger than 2 years.
- Pneumonia was more frequent in school-aged children, while younger children needed oxygen therapy more.
- Over half of patients (51%) exhibited extrapulmonary manifestations, including gastrointestinal and dermatological symptoms; neurological symptoms were more common in older children.
Conclusions:
- Mycoplasma pneumoniae is a frequent cause of pediatric hospitalization, affecting even infants.
- The clinical spectrum of MP is broad, encompassing significant extrapulmonary involvement.
- Clinicians must consider the diverse presentations of MP to ensure timely diagnosis and appropriate care.
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