Clinical Characteristics and Risk Factors of Pulmonary Embolism in Adults Due to Mycoplasma Pneumoniae Pneumonia

CHEST Journal ◽  
2016 ◽  
Vol 149 (4) ◽  
pp. A520
Author(s):  
Ze-Ying Liu ◽  
Shuang Liu ◽  
Jin-Hua Liu
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Mycoplasma Pneumoniae ◽  
Clinical Characteristics ◽  
Mycoplasma Pneumoniae Pneumonia

scholarly journals Clinical characteristics and risk factors of Fulminant Mycoplasma pneumoniae pneumonia in children

2020 ◽  
Author(s):  
yaoyao ling ◽  
Tongqiang Zhang ◽  
Zhenli Zhu ◽  
Jiao Tian ◽  
yongsheng xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Mycoplasma Pneumoniae ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Radiological Findings ◽  
Mycoplasma Pneumoniae Pneumonia ◽  
D Dimer

Abstract BACKGROUND: Analyze the clinical characteristics of Fulminant Mycoplasma pneumoniae pneumonia (FMPP), and explore the related factors predicting FMPP. METHODS: A retrospective case-control study was performed on 345 children with Mycoplasma pneumoniae pneumonia (MPP) hospitalized in our Hospital from January 2017 to June 2019. The clinical features, laboratory data and radiological findings were compared between the FMPP group, refractory Mycoplasma pneumoniae pneumonia (RMPP)group and general Mycoplasma pneumoniae pneumonia (GMPP) group. RESULTS: FMPP patients (n=69) had more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings(P<0.05). And the days of fever and the days in hospital were longer, and FMPP patients also need more complicated treatments(P<0.05). Meanwhile, the levels of white blood cell count(WBC) ,C-reactive protein(CRP), lactic dehydrogenase (LDH), interleukin (IL)-6,ferritin, D-dimer, fibrinogen(FG),alanine aminotransferase(ALT) and the percentage of neutrophils in the FMPP group were significantly higher than those in the RMPP group and the GMPP group (both P<0.05). In ROC curve analysis, the percentage of neutrophils, WBC, CRP, LDH, IL-6, ferritin, D-dimer and ALT were contributed to identify FMPP patients. Multivariate logistic regression analysis showed that ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion had significant predictive effects on the early diagnosis of FMPP (P<0.01). Conclusion: FMPP patients presented more serious clinical manifestations. Ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion were high risk factors for FMPP.

scholarly journals Clinical characteristics of refractory Mycoplasma pneumoniae pneumonia in children treated with glucocorticoid pulse therapy

2020 ◽  
Author(s):  
Zhenli Zhu ◽  
Tongqiang Zhang ◽  
Wei Guo ◽  
Yaoyao Ling ◽  
Jiao Tian ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Pulse Therapy ◽  
Methylprednisolone Pulse Therapy ◽  
Methylprednisolone Pulse ◽  
Conventional Dose ◽  
Group I ◽  
Group Ii ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract Objective: To observe the effect of corticosteroids in the treatment of children with refractory Mycoplasma pneumoniae pneumonia（RMPP）under different doses, to summarize the clinical characteristics of children treated with glucocorticoid pulse therapy.Methods: The clinical data of 125 children with RMPP hospitalized in Tianjin Children's Hospital from September 2018 to October 2019 were retrospectively analyzed. They were divided into two groups according to the dose of hormone. Group I was given conventional dose methylprednisolone 2mg/kg/day (<200mg/day) (n=81), and group II was treated with methylprednisolone pulse therapy ≥200mg/day(n=44). Compare the clinical manifestations, laboratory findings, and imaging between the two groups of children, and use meaningful related indicators as ROC curves to find reference indicators for pulse therapy.Results: (1)The age and weight of the group II were greater than the group I（P<0.05）. (2) The symptoms of group II were more serious than group I, with higher incidence of hypoxemia, longer fever, longer hospital stays, higher incidence of extrapulmonary complications, and more severe radiological findings (P<0.05). (3)The more severe the disease was, the higher hormone amount，use rate of gamma globulin，use rate of bronchoscopy , and incidence of plastic bronchitis (P<0.05)were.(4) WBC, CRP, LDH, FER, D-D dimer, APTT, TT, PCT, IL-6 and the percentage of neutrophils in peripheral blood in Group II were higher than those in Group I(P<0.05). Moreover, the lymphocyte percentage level in group II was lower than that in group I(P<0.05). (5) In ROC curve analysis, CRP, LDH, FER, and neutrophils of leukocyte classification were independent related factors that could be used as valuable predictors of methylprednisolone pulse therapy for RMPP in children. The cut-off values were CRP 44.45 mg/L, LDH 590 IU/L, FER 411 ng/L, and neutrophils in leukocyte classification were 73.75%, respectively.Conclusions: Conventional dose methylprednisolone can improve the clinical symptoms and imaging findings of most children with RMPP rapidly. However, CRP 44.45 mg/L, LDH 590 IU/L, FER 411 ng/L, neutrophil 73.75%, lung consolidation and pleural effusion were found in RMPP patients, which should be treated with pulse dose of methylprednisolone in time to reduce the incidence of severe RMPP and the occurrence of severe sequelae.

scholarly journals Dual energy spectral CT imaging of pulmonary embolism with Mycoplasma pneumoniae pneumonia in children

2020 ◽  
Author(s):  
Lixin Yang ◽  
Jihang Sun ◽  
Jiangying Li ◽  
Tong Yu ◽  
Bei Wang ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Mycoplasma Pneumoniae ◽  
Iodine Concentration ◽  
Pulmonary Angiography ◽  
Dual Energy ◽  
Normal Lung ◽  
Spectral Ct ◽  
Significant Difference ◽  
Perfusion Defects ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract Background: Pulmonary embolism (PE) associated with Mycoplasma pneumoniae pneumonia (MPP) in children has already attracted more attention. We aimed to evaluate the application of dual-energy spectral CT in diagnosing PE in children with MPP.Methods: Eight-three children with MPP and highly suspected PE, underwent CT pulmonary angiography (CTPA) with spectral imaging mode. Noise, clot-to-artery contrast-to-noise ratio, image quality and diagnosis confidence were calculated and assessed on nine monochromatic image sets (40 to 80keV). CTPA images were observed for the presence, localization, and embolic degrees of PE. Emboli were divided between intra and extra-consolidation. For extra-consolidation clots, iodine concentration (IC) of perfusion defects and normal lung, perfusion defects of 4 children before and after the treatment were measured and compared. For intra-consolidation clots, IC of consolidation areas with clots and consolidation areas without clot were measured and compared.Results: The optimal energy level for detecting PE in children was 55 keV. 116 clots (29 extra consolidations) were found in 25 children, IC of defect regions associated with PE was 0.69±0.28mg/mL (extra-consolidations) and 0.90±0.23mg/mL (intra-consolidations), both significantly lower than the 2.76±0.45mg/mL in normal lungs and 10.25±1.76mg/mL in consolidations without clots (P<0.001). Significant difference was found in the presence or absence of perfusion defects between occlusive clots and nonocclusive clots(P<0.001). IC of the perfusion defects significantly increased after treatment (P<0.001).Conclusions: In spectral CTPA 55 keV images optimize PE detection for children. and MD images quantify pulmonary blood flow of PE, and may help to detect small clots and quantify embolic degrees.

scholarly journals GM-CSF and HMGB1 level were associated with the clinical characteristics and prognosis of childhood refractory mycoplasma pneumoniae pneumonia

2020 ◽  
Author(s):  
Lianfu Cao ◽  
Haijiao Lin ◽  
Hongjun Yu ◽  
Yongji Wang
Keyword(s):  
Bronchoalveolar Lavage ◽  
Clinical Diagnosis ◽  
Mycoplasma Pneumoniae ◽  
Predictive Value ◽  
Clinical Characteristics ◽  
Roc Analysis ◽  
Lavage Fluid ◽  
Hmgb1 Level ◽  
Gm Csf ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract Background: To analyze the relationship between granulocyte-macrophage colony-stimulating factor (GM-CSF) and high mobility group box 1 (HMGB1) level in alveolar lavage fluid with the clinical characteristics and prognosis of children refractory mycoplasma pneumoniae pneumonia (MPP), so as to provide reliable targets for clinical diagnosis and treatment. Methods: A total of 106 children diagnosed with MPP and prepared for bronchoalveolar lavage therapy were selected in this study, which were divided into 2 groups according to clinical diagnosis: those showing clinical and radiological deterioration despite appropriate antibiotic therapy for ≥7 days were classified into refractory MPP group (n=47), while the others were classified into non-refractory MPP group (n=59). The data of physical examination, treatment and outcome were collected. In addition, the GM-CSF and HMGB1 levels in alveolar lavage fluid during each bronchoalveolar lavage therapy were detected by ELISA kits. Results: There was no significant difference in age, sex, course of fever, the highest temperature, WBC, L, PLT, ALT, AST, CK-MB, D-D, CK, IgG, IgA, IgM, C3, and C4 between refractory MMP group and non-refractory MMP group on admission (P＞0.05). The levels of N, CRP, PCT, and LDH in refractory MPP group were higher than those in non-refractory MPP group, the difference had statistical significance (P＜0.05). Both GM-CSF and HMGB1 levels were positively correlated with traditional indicators N, CRP, PCT and LDH (r=0.611-0.785, P<0.05). ROC analysis results showed that CRP, GM-CSF and HMGB1 had predictive value for refractory MPP attack (AUC=0.636, 0.657, 0.651, P<0.05). Logistic regression analysis results showed GM-CSF and HMGB1 were independent factors for refractory MPP (B＞1.0, P<0.05). ROC analysis results showed that GM-CSF and HMGB1 at 2nd bronchoalveolar lavage therapy had predictive value for long hospital stay (>28 d) and poor prognosis of refractory MPP (AUC=0.782-0.825, P < 0.05). Conclusion: The level of GM-CSF and HMGB1 in alveolar lavage fluid is closely related to the occurrence and development of refractory MPP, which can be used as an auxiliary indicator for clinical diagnosis and prognosis evaluation, and has certain guiding significance for its clinical treatment.

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