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Mycoplasma infection aggravates cardiac involvements in Kawasaki diseases: a retrospective study
Guoyan Lu1, Xing Li1, Jie Tang1
1Department of Pediatrics, Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Background:
Mycoplasma pneumoniae (MP) infection serves as a substantial cofactor in Kawasaki disease (KD) among patients. Although the dominant issue triggering KD has recently focused on MP infection, the complete demonstration of the relationship between MP infection and KD remains elusive. This study endeavors to scrutinize and compare the clinical manifestations and cardiac involvement between MP-triggered KD and non-infection-associated KD.
Method:
This retrospective study (2023-039, approved by the Institutional Review Board of West China Second University Hospital of Sichuan University) encompassed 247 consecutive patients diagnosed with KD between June 2017 and December 2022. Patients were categorized into two groups: the MP group (n = 38) and the non-MP group (n = 209). Univariable analysis was utilized to discern differences in clinical features, severity of inflammation, and initial or persistent cardiac complications between the two groups.
Results:
The MP group exhibited a more intricate clinical profile compared with the non-MP group, characterized by prolonged hospital stays, a higher incidence of incomplete KD, and elevated comorbidities. In addition, MP infection correlated with severe hematological disorders, coagulation dysfunction, and myocardial injuries. Our findings revealed that MP infection led to prolonged inflammation after initial treatment with intravenous immunoglobulin. Although initial cardiac assessments failed to discern disparities between the two groups, MP infection notably exacerbated coronary artery aneurysms (CAAs), resulting in sustained dilation.
Conclusions:
Recognizing MP infection as a significant infectious factor associated with KD is imperative. In patients with KD, MP infection significantly prolongs inflammation and causes hematological disturbances during the initial treatment phase. Moreover, the presence of MP infection exacerbates the progression of CAAs and myocardial injuries during the subacute phase of KD, consequently contributing to the persistence of CAAs.
Insights
Mycoplasma pneumoniae infection in Kawasaki disease (KD) prolongs inflammation and worsens cardiac issues, including coronary artery aneurysms. This highlights MP as a key cofactor in KD development and progression.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiology
Background:
- Mycoplasma pneumoniae (MP) is a suspected cofactor in Kawasaki disease (KD).
- The precise relationship between MP infection and KD pathogenesis remains unclear.
- This study compares clinical and cardiac outcomes in KD patients with and without MP infection.
Purpose of the Study:
- To compare clinical manifestations and cardiac involvement in MP-triggered KD versus non-infection-associated KD.
- To elucidate the impact of MP infection on KD severity and treatment response.
- To investigate the role of MP in the development and progression of cardiac complications in KD.
Main Methods:
- Retrospective study of 247 KD patients (June 2017 - December 2022).
- Patients divided into MP group (n=38) and non-MP group (n=209).
- Univariable analysis used to compare clinical features, inflammation, and cardiac complications.
Main Results:
- MP group had longer hospital stays, more incomplete KD, and higher comorbidities.
- MP infection correlated with severe hematological disorders, coagulation dysfunction, and myocardial injury.
- MP infection prolonged inflammation post-IVIG and exacerbated coronary artery aneurysms (CAAs).
Conclusions:
- MP infection is a significant factor in KD, prolonging inflammation and causing hematological disturbances.
- MP exacerbates CAA progression and myocardial injury during the subacute phase of KD.
- MP infection contributes to the persistence of CAAs in KD patients.
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