Clinical Characteristics of Mycoplasma pneumoniae Pneumonia in Children and Risk Factors for Progression to Severe...

To understand the clinical characteristics of severe and nonsevere Mycoplasma pneumoniae pneumonia (MPP) in children and analyze the risk factors for severe Mycoplasma pneumoniae pneumonia (SMPP), providing a basis for early clinical diagnosis and treatment of SMPP.

A retrospective analysis was conducted on 146 children with MPP admitted to pediatric wards 1-4 of Zunyi First People's Hospital from August 2024 to June 2025. According to the severity of their condition, the patients were divided into a severe group (n = 49) and a nonsevere group (n = 97). Clinical manifestations, imaging data, and laboratory indicators were compared between the two groups, and logistic regression analysis was used to summarize the risk factors for pediatric SMPP.

(1) The duration of fever and cough was significantly longer in the severe MPP group than in the nonsevere group (p < 0.05). Compared with those in the nonsevere group, instances of prematurity, intrauterine infection at birth, pulmonary consolidation, pleural effusion, high fever, wheezing, and difficulty breathing were significantly more frequent in the severe group (p < 0.05). (2) Laboratory indicators, such as C-reactive protein levels, lactate dehydrogenase levels, D-dimer levels, ferritin levels, the neutrophil ratio, and serum amyloid A levels, were significantly greater in the severe group than in the nonsevere group (p < 0.05). (3) The risk factors for SMPP included prematurity (OR = 4.747; 95% CI: 1.259 ∼ 17.891; p = 0.021), pulmonary consolidation (OR = 5.277; 95% CI: 1.372 ∼ 20.301; p = 0.016), high fever (OR = 25.597; 95% CI: 6.760 ∼ 96.926; p < 0.001), wheezing (OR = 6.913; 95% CI: 1.837 ∼ 26.017; p = 0.004), and difficulty breathing (OR = 5.990; 95% CI: 1.451 ∼ 24.722; p = 0.013).

Children with SMPP have prolonged fever and cough, more severe clinical symptoms, and significantly elevated inflammation-related laboratory indicators. Prematurity, pulmonary consolidation, high fever, wheezing, and difficulty breathing are easily accessible baseline warning indicators for early identification of children at high risk of progression to SMPP. Strengthening early recognition and timely intervention in patients presenting with these factors may help optimize clinical management and improve outcomes.