Factors associated with various clinical manifestations of Mycoplasma pneumonia in children

Yoo-Na Kim; Chul Hyue Park; Su Hee Kim; Soo Jin Yoo; Hyo-Bin Kim

doi:10.4168/aard.2013.1.4.357

Journal List > Allergy Asthma Respir Dis > v.1(4) > 1058985

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Park, Kim, Yoo, and Kim: Factors associated with various clinical manifestations of Mycoplasma pneumonia in children

Original Article

Allergy, Asthma & Respiratory Disease 2013; 1(4): 357-361.

Published online: 31 December 2013

DOI: https://doi.org/10.4168/aard.2013.1.4.357

Factors associated with various clinical manifestations of Mycoplasma pneumonia in children

Yoo-Na Kim¹, Chul Hyue Park¹, Su Hee Kim¹, Soo Jin Yoo², Hyo-Bin Kim¹

¹Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea.

²Department of Laboratory Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.

Correspondence to: Hyo-Bin Kim. Department of Pediatrics, Inje University Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-707, Korea. Tel: +82-2-950-8852, Fax: +82-2-950-8883, hbkim@paik.ac.kr

Received 18 March 2013 Revised 4 August 2013 Accepted 30 August 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Abstract

Purpose

Mycoplasma pneumonia (MP) is a major cause of community-acquired pneumonia in children and young adults. We aimed to investigate the factors that may influence on the clinical manifestations of MP in children.

Methods

A total of 109 admitted children from October 2011 to February 2012 were prospectively enrolled with physical examination and laboratory tests (complete blood count, C-reactive protein [CRP], and particle agglutinin assay). The diagnosis of MP was made when there was an infiltration on the chest X-ray and the particle agglutination test was once over 1:640 or showed 4-fold increase in serial tests. They were grouped by age, fever duration after treatment, presence of pleural effusion and wheezing.

Results

Preschool children showed shorter duration of fever (P=0.001), more wheezing (P<0.001), lower segmented neutrophil (P<0.001), and lower CRP levels (P=0.004) compared to schoolchildren. Prolonged fever (>3 days) and pleural effusion were developed in children with higher CRP (P=0.018 and P=0.007). Wheezing has been developed in children with younger age (P=0.007).

Conclusion

Younger age was a risk factor to develop wheezing in MP and prolonged fever and pleural effusion were more likely to develop in children with higher CRP.

Keywords: Mycoplasma pneumonia, Age factors, Fever, Pleural effusion, Wheezing, C-reactive protein

Figures and Tables

Table 1

Characteristics of the subjects

Values are presented as mean±standard deviation or number (%).

WBC, white blood cell; CRP, C-reactive protein.

Table 2

Comparison of clinical and laboratory findings by duration of fever

Values are presented as mean±standard deviation or number (%).

WBC, white blood cell; CRP, C-reactive protein.

^*Unadjusted value. ^†P=0.009 after adjusted for age, past history of recurrent wheezing and segmented neutrophils.

Table 3

Comparison of clinical and laboratory findings depending on pleural effusion

Values are presented as mean±standard deviation or number (%).

WBC, white blood cell; CRP, C-reactive protein.

^*Unadjusted value. ^†P=0.001 after adjusted for age, past history of recurrent wheezing and segmented neutrophils.

Table 4

Comparison of clinical and laboratory findings depending on wheezing

Values are presented as mean±standard deviation or number (%).

WBC, white blood cell; CRP, C-reactive protein.

^*Unadjusted value. ^†P=0.003 after adjusted for past history of recurrent wheezing, segmented neutrophils and CRP.

References

1. Atkinson TP, Balish MF, Waites KB. Epidemiology, clinical manifestations, pathogenesis and laboratory detection of Mycoplasma pneumoniae infections. FEMS Microbiol Rev. 2008; 32:956–973.

2. Lee KY. Pediatric respiratory infections by Mycoplasma pneumoniae. Expert Rev Anti Infect Ther. 2008; 6:509–521.

3. Kim JW, Seo HK, Yoo EG, Park SJ, Yoon SH, Jung HY, et al. Mycoplasma pneumoniae pneumonia in Korean children, from 1979 to 2006-a meta-analysis. Korean J Pediatr. 2009; 52:315–323.

4. Lee SH, Noh SM, Lee KY, Lee HS, Hong JH, Lee MH, et al. Clinico-epidemiologic Study of Mycoplasma pneumoniae Pneumonia (1993 through 2003). Korean J Pediatr. 2005; 48:154–157.

5. Youn YS, Lee KY, Hwang JY, Rhim JW, Kang JH, Lee JS, et al. Difference of clinical features in childhood Mycoplasma pneumoniae pneumonia. BMC Pediatr. 2010; 10:48.

6. Hong SJ. The role of Mycoplasma pneumoniae infection in asthma. Allergy Asthma Immunol Res. 2012; 4:59–61.

7. Hong JY, Nah SY, Nam SG, Choi EH, Park JY, Lee HJ. Occurrence of Mycoplasma pneumoniae pneumonia in Seoul, Korea, from 1986 to 1995. J Korean Pediatr Soc. 1997; 40:607–613.

8. Nagayama Y, Sakurai N, Yamamoto K, Honda A, Makuta M, Suzuki R. Isolation of Mycoplasma pneumoniae from children with lower-respiratory-tract infections. J Infect Dis. 1988; 157:911–917.

9. Defilippi A, Silvestri M, Tacchella A, Giacchino R, Melioli G, Di Marco E, et al. Epidemiology and clinical features of Mycoplasma pneumoniae infection in children. Respir Med. 2008; 102:1762–1768.

10. Kim KW, Kim KE. Mycoplasma and chlamydia infection in Korea. Korean J Pediatr. 2009; 52:277–282.

11. Youn YS, Lee KY. Mycoplasma pneumoniae pneumonia in children. Korean J Pediatr. 2012; 55:42–47.

12. Xia Y, Wu CK, Tang YY, Cao J. Differences in the clinical features of Mycoplasma pneumoniae pneumonia among children of different ages. Zhongguo Dang Dai Er Ke Za Zhi. 2013; 15:179–182.

13. Lieberman D, Lieberman D, Printz S, Ben-Yaakov M, Lazarovich Z, Ohana B, et al. Atypical pathogen infection in adults with acute exacerbation of bronchial asthma. Am J Respir Crit Care Med. 2003; 167:406–410.

14. Esposito S, Blasi F, Arosio C, Fioravanti L, Fagetti L, Droghetti R, et al. Importance of acute Mycoplasma pneumoniae and Chlamydia pneumoniae infections in children with wheezing. Eur Respir J. 2000; 16:1142–1146.

15. Kim KW, Lee BC, Lee KE, Kim ES, Song TW, Park MY, et al. Mycoplasma pneumoniae-induced production of proasthmatic mediators in airway epithelium. Korean J Pediatr. 2006; 49:977–982.

16. Yang J, Hooper WC, Phillips DJ, Talkington DF. Cytokines in Mycoplasma pneumoniae infections. Cytokine Growth Factor Rev. 2004; 15:157–168.

17. Lazaar AL, Panettieri RA Jr. Airway smooth muscle: a modulator of airway remodeling in asthma. J Allergy Clin Immunol. 2005; 116:488–495.

18. Lee CG, Link H, Baluk P, Homer RJ, Chapoval S, Bhandari V, et al. Vascular endothelial growth factor (VEGF) induces remodeling and enhances TH2-mediated sensitization and inflammation in the lung. Nat Med. 2004; 10:1095–1103.

19. Kim JT. Laboratory diagnosis of Mycoplasma infection. Pediatr Allergy Respir Dis. 2006; 16:23–25.

20. Waites KB. New concepts of Mycoplasma pneumoniae infections in children. Pediatr Pulmonol. 2003; 36:267–278.

21. Chan PW, Lum LC, Ngeow YF, Yasim MY. Mycoplasma Pneumoniae infection in Malaysian children admitted with community acquired pneumonia. Southeast Asian J Trop Med Public Health. 2001; 32:397–401.

22. Kim NH, Lee JA, Eun BW, Shin SH, Chung EH, Park KW, et al. Comparison of polymerase chain reaction and the indirect particle agglutination antibody test for the diagnosis of Mycoplasma pneumoniae pneumonia in children during two outbreaks. Pediatr Infect Dis J. 2007; 26:897–903.

TOOLS

Similar articles