Clinical differences according to radiological patterns in childhood Mycoplasma pneumoniae pneumonia

Ga Young Park; Young Im Lee; Meeyong Shin; Jae Ock Park; Chang Hwi Kim

doi:10.4168/aard.2013.1.4.362

Journal List > Allergy Asthma Respir Dis > v.1(4) > 1058986

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Park, Lee, Shin, Park, and Kim: Clinical differences according to radiological patterns in childhood Mycoplasma pneumoniae pneumonia

Original Article

Allergy, Asthma & Respiratory Disease 2013; 1(4): 362-369.

Published online: 31 December 2013

DOI: https://doi.org/10.4168/aard.2013.1.4.362

Clinical differences according to radiological patterns in childhood Mycoplasma pneumoniae pneumonia

Ga Young Park, Young Im Lee, Meeyong Shin, Jae Ock Park, Chang Hwi Kim

Department of Pediatrics, Soonchunhyang University College of Medicine, Cheonan, Korea.

Correspondence to: Meeyong Shin. Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon 420-767, Korea. Tel: +82-32-621-5406, Fax: +82-32-621-5560, smy0218@schmc.ac.kr

Received 31 May 2013 Revised 30 August 2013 Accepted 8 September 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

This study was conducted to evaluate the difference of clinical characteristics of pneumonia in children caused by Mycoplasma pneumoniae, according to their chest radiographic patterns.

Methods

We analyzed medical records of 921 children who were admitted to Soonchunhyang University Buchon Hospital due to M. pneumoniae pneumonia from January 2008 to December 2011. Enrolled children were divided into 2 groups by radiological patterns: lobar/lobular pneumonia group (group 1) and broncho/interstitial pneumonia group (group 2).

Results

The number of patients in group 1 was 295 (32%) and in group 2, 626 (68%). Lobar/lobular pneumonia occurred in older children compared to broncho/interstitial pneumonia (mean age, 6.4 years vs. 4.2 years; P=0.00). Group 1 had significantly longer durations of fever and hospitalization than group 2. The frequency of pleural effusion was significantly higher in group 1. Erythrocyte sedimentation rate and C-reactive protein values were higher in group 1. Coinfections with respiratory viruses were more frequent in group 2. The history of allergic diseases were more common in group 2 (P=0.006). In 2011, lobar/lobular pneumonia was more frequent and the duration of fever was longer compared with 2008-2010.

Conclusion

In M. pneumoniae pneumonia, patients with lobar/lobular pneumonia were more older and had more severe clinical features and laboratory findings. Because there was an outbreak with severe clinical course in 2011, we wonder that the outbreak was related to the macrolide resistant M. pneumoniae. Careful attention about clinical course and consequences of patients with lobar/lobular pneumonia is required.

Keywords: Mycoplasma pneumoniae pneumonia, Child, Lobar pneumonia

Figures and Tables

Fig. 1

Age distribution of 921 patients with Mycoplasma pneumoniae pneumonia.

Fig. 2

Yearly distribution of 921 patients with Mycoplasma pneumoniae pneumonia.

Fig. 3

Monthly distribution of patients with Mycoplasma pneumoniae pneumonia (2008-2011).

Fig. 4

Computed tomography findings of bronchiolitis obliterans after Mycoplasma pneumoniae pneumonia.

Table 1

Clinical characteristics of Mycoplasma pneumoniae pneumonia according to the radiologic patterns

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

^*Tests for other respiratory pathogens were performed in 349 among 921 patients with M. pnuemoniae pnuemonia.

Table 2

Laboratory findings of Mycoplasma pneumoniae pneumonia according to the radiologic patterns

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

CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; AST, aspartate aminotransferase; ALT, alanine aminotransferase.

^*Eosinophilia was defined as ≥5% of leukocytes. ^†Follow-up complete blood count was performed in 295 among 921 patients with M. pnuemoniae pnuemonia.

Table 3

Combined diseases with Mycoplasma pneumoniae pneumonia according to the radiologic patterns

Values are presented as number (%).

^*Anemia was defined as <10.0 g/dL of hemoglobin level.

Table 4

Comparison of clinical characteristics of Mycoplasma pneumoniae pneumonia between 2011 and 2008-2010

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

Table 5

Comparison of laboratory findings of Mycoplasma pneumoniae pneumonia between 2011 and 2008-2010

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

CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; AST, aspartate aminotransferase; ALT, alanine aminotransferase.

^*Eosinophilia was defined as ≥5% of leukocytes.

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