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 Identifying clinical factors associated with Fulminant Mycoplasma pneumoniae pneumonia in children

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

Abstract BACKGROUND: Analyze the clinical characteristics of Fulminant Mycoplasma pneumoniae pneumonia (FMPP), and identify 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 a higher incidence of extra-pulmonary complications and more serious radiological findings(P<0.05), besides the days of fever and the days in the hospitals were longer. 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 (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 have 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 clinical factors for FMPP.

scholarly journals Identify clinical factors related to Mycoplasma pneumoniae pneumonia with hypoxia in children

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

Abstract Background: Analyze the clinical characteristics of Mycoplasma pneumoniae pneumonia with hypoxia in children, and identify the related factors of hypoxia in MPP. 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 MPP with hypoxia, refractory Mycoplasma pneumoniae pneumonia (RMPP) and general Mycoplasma pneumoniae pneumonia (GMPP) groups. Results: MPP with hypoxia patients (n=69) had a higher incidence of extra-pulmonary complications and more serious radiological findings(P<0.05), besides the days of fever and in the hospitals were longer. And they 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 MPP with hypoxia group were significantly higher than those in the RMPP group and the GMPP group (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 MPP with hypoxia patients. Multivariate logistic regression analysis showed that ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion had important effects on hypoxia in MPP (P<0.01).Conclusion: MPP with hypoxia patients presented more serious clinical manifestations. Ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion were related clinical factors for hypoxia in MPP.

scholarly journals Analysis of Clinical Characteristics and Risk Factors of Plastic Bronchitis in Children With Mycoplasma pneumoniae Pneumonia

2021 ◽  
Vol 9 ◽  
Author(s):  
Haiqin Zhong ◽  
Rong Yin ◽  
Ran Zhao ◽  
Kun Jiang ◽  
Chao Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Mycoplasma Pneumoniae ◽  
Clinical Characteristics ◽  
Univariate Analysis ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Plastic Bronchitis ◽  
Complement 3 ◽  
Strong Inflammatory Response

Objective: To analyze the clinical characteristics of plastic bronchitis (PB) in children with Mycoplasma pneumoniae pneumonia (MPP) in order to explore its risk factors.Methods: A retrospective analysis was performed in MPP children receiving bronchoscopy admitted to department of respiratory medicine in Shanghai Children's Hospital from January 2018 to December 2020. According to the bronchoscopic findings, the patients were divided into PB group and non-PB group. The clinical manifestations, laboratory examination, etiology, treatment methods and outcomes of the children were analyzed. Logistic regression was used to analyze the risk factors for PB in children with MPP.Results: A total of 296 children with MPP were enrolled in the study, including 42 (14.2%) children in the PB group and 254 (85.8%) children in the non-PB group. There was no difference in the ratios of gender, age, proportion of fever, cough, wet rales, and wheezing rales between the two groups (P &gt; 0.05). The univariate analysis showed that there were significant differences between the PB group and the non-PB group in LDH, D-dimer, CD3+CD4+(%), CD3+CD4+/CD3+CD8+, CD3 count, CD4 count, CD8 count, complement 3, IL8, IL-1β, IL-2, IL-10 (P &lt; 0.05). The multivariate logistic regression analysis showed that fever duration &gt; 12 d, IL-8 &gt; 2,721.33 pg/ml, LDH &gt; 482 U/L and complement 3 &lt;1.02 g/L were independent risk factors for PB in children with MPP.Conclusions: Children with PB caused by MPP have protracted fever, a strong inflammatory response and immune function disturbance.

scholarly journals Clinical significance of D-dimer level in refractory Mycoplasma pneumoniae pneumonia

2020 ◽  
Author(s):  
Xia Huang ◽  
Dan Li ◽  
Feng Liu ◽  
Deyu Zhao ◽  
Yifan Zhu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Inflammatory Response ◽  
Clinical Significance ◽  
Mycoplasma Pneumoniae ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Good Ability ◽  
Excessive Inflammatory Response ◽  
Mycoplasma Pneumoniae Pneumonia ◽  
D Dimer

Abstract Background: The levels of serum D-dimer (D-D) in children with Mycoplasma pneumoniae pneumonia (MPP) were assessed to explore the clinical significance of D-D levels in refractory MPP (RMPP). Method: A total of 430 patients with MPP were enrolled between January 2015 and December 2015 and divided into a general MPP (GMPP) group (n=306) and a RMPP group (n=124). Clinical data, D-D level, white blood cell (WBC) count, proportion of neutrophils (N%), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), alanine transaminase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) were compared between the two groups. Multivariate logistic regression was performed to identify independent predictors of RMPP. Results: (1) Hospitalization time, preadmission fever duration, total fever duration, WBC, N %, CRP, LDH, ESR, ALT, AST, and D-D were significantly higher in the RMPP group than those in the GMPP group (all P<0.05). (2) Correlation analysis showed that D-D was positively correlated with WBC, CRP, ESR, and LDH, and could be used to jointly evaluate the severity of the disease. (3) Multivariate logistic regression analysis identified preadmission fever duration, CRP, LDH and DD as independent risk factors for RMPP (all P<0. 05). D-D had the highest predictive power for RMPP (P<0.01). The D-D level also had a good ability to predict pleural effusion and liver injury (all P<0.01). Conclusion: Serum D-D levels were significantly increased in patients with RMPP, indicating that excessive inflammatory response and vascular endothelial injury with prolonged duration existed in this patient population. Increased levels of serum D-D may be used as an early predictor of RMPP and the occurrence of complications. Our findings provide a theoretical basis for the early diagnosis of RMPP, early intervention and excessive inflammatory response in the pathogenesis of mycoplasma.

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 Clinical Features of Plastic Bronchitis Related to Respiratory Tract Infection in 269 Children

2022 ◽  
Author(s):  
xiaojian cui ◽  
Wei Guo ◽  
Lihua Zhao ◽  
Tongqiang Zhang ◽  
Jiafeng Zheng ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Clinical Features ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Fiberoptic Bronchoscopy ◽  
Plastic Bronchitis ◽  
D Dimer

Abstract Background. Plastic bronchitis (PB) is a pulmonary disease characterized by the formation of bronchial casts (BCs) that lead to airway blockage. The study aimed to investigate the clinical features of PB related to respiratory tract infection. Methods. A retrospective analysis was performed on data collected over a 5-year period (from January 2015 to December 2019) on children with PB (n=269). The clinical manifestations, laboratory data, imaging findings and management, were investigated. The single fiberoptic bronchoscopy (FOB, n=144) and multiple-treatment groups (n=125) were compared.Results. A total of 269 PB children were included with a mean age of 6.7 ± 2.8 years. The majority of cases (n=241, 89.6%) were diagnosed with Mycoplasma pneumonia (MP) infection. The mean duration of fever and hospitalization was 10.6 ± 3.7 and 9.3 ± 3.2 days, respectively. All patients presented with cough and fever, 62 (23.0%) suffered from hypoxemia, and 144 (53.5%) had extrapulmonary complications. Higher levels of ESR, CRP, PCT, IL-6, LA, LDH, FER and D-dimer were observed. CT findings, including pulmonary consolidation, segmental or lobar atelectasis, pleural effusion and pleural thickening, were observed in 97.4%, 46.5%, 47.9% and 63.2% of cases, respectively. Furthermore, multivariate logistic regression analysis showed that N% >75.5%, LDH >598.5U/L, and D-dimer>1.2mg/L were independent risk factors for multiple therapeutic FOB. Conclusions. MP is a major pathogen responsible for PB in children. Patients with PB are more likely to experience persistent fever and excessive inflammation and have severe radiological findings. FOB is an effective treatment for patients with PB, and children may require multiple FOBs for cast removal. N% >75.5%, LDH >598.5U/L and D-dimer > 1.2mg/L are independent predictors of multiple FOB treatment.

scholarly journals Early prediction of necrotizing pneumonia from mycoplasma pneumoniae pneumonia with large pulmonary lesions in children

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yunlian Zhou ◽  
Mengting Hu ◽  
Bei Ye ◽  
Zhimin Chen ◽  
Yuanyuan Zhang
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Clinical Manifestations ◽  
Necrotizing Pneumonia ◽  
Radiological Findings ◽  
Roc Curve Analysis ◽  
Laboratory Findings ◽  
Pulmonary Lesions ◽  
Ct Value ◽  
Ifn Γ ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract To compare the different features of necrotizing pneumonia (NP) and non-NP (NNP) caused by Mycoplasma pneumoniae pneumonia (MPP) with large pulmonary lesions, and explore the predictor for NP to differentiate from MPP. A retrospective study of MPP patients with large pulmonary lesions hospitalized from January 2008 to December 2019 was enrolled, and clinical manifestations, laboratory findings, radiological findings were analyzed. Of 135 MPP patients with large pulmonary lesions, 56 were in the NP group, 79 were in the NNP group. We found the median length of fever days were much longer in NP group than those in NNP group. Higher levels of WBC, CRP, LDH, IL-6 in NP group were observed. Furthermore, the incidence of pulmonary consolidation was much higher in NP patients than that in NNP patients, while the CT value of large pulmonary lesion was much lower in NP patients. In ROC curve analysis, the cut-off values for the CT value and IFN-γ were 36.43 and 7.25 pg/ml, respectively. NP caused by MPP might be easier to suffer from prolonged clinical course, severe laboratory and radiological findings. CT value of large pulmonary lesions and IFN-γ could be used as biomarkers to predict NP from MPP with large pulmonary lesions in children.

scholarly journals The Level of D-Dimer Is Positively Correlated With the Severity of Mycoplasma pneumoniae Pneumonia in Children

2021 ◽  
Vol 11 ◽  
Author(s):  
Yan Zheng ◽  
Lingling Hua ◽  
Qiannan Zhao ◽  
Mengyao Li ◽  
Meixia Huang ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Mycoplasma Pneumoniae ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Pulmonary Complications ◽  
Normal Group ◽  
Fever Hospital ◽  
Duration Of Treatment ◽  
Group D ◽  
D Dimer

ObjectiveMycoplasma pneumoniae pneumonia (MPP) is an important disease in children. Studies have demonstrated that the levels of D-dimer are elevated in some children with MPP, especially those with thrombotic complications. However, the potential association between MPP and D-dimer remains unclear. In our study, we sought to explore the relationship between the levels of plasma D-dimer and clinical characteristics of MPP patients.MethodsRetrospective analysis was conducted on 356 patients who were hospitalized in our hospital for MPP between January 1, 2017, and December 31, 2019. According to the peak value of D-dimer, patients were divided into three groups: the normal group (D-dimer&lt;0.55 mg/L), the mild-moderately elevated group (D-dimer 0.55–5.5 mg/L) and the severely elevated group (D-dimer &gt;5.5 mg/L). The demographic and clinical information, radiological findings, laboratory data, and treatments of patients were compared among different groups.Results106 patients were in the normal group, 204 patients were in the mild-moderately elevated group, and 46 patients were in the severely elevated group. More severe clinical and radiographic manifestations, longer length of fever, hospital stay and antibiotic therapy duration, higher incidences of extra-pulmonary complications, refractory MPP (RMPP), severe MPP (SMPP) were found in the elevated group, when compared with the normal group (P&lt;0.01). Meanwhile, we found that the percentage of neutrophil (N%) and CD8+ lymphocyte (CD8+%), C-reactive protein (CRP), lactate dehydrogenase (LDH), interleukin (IL)-6, IL-10, and interferon-gamma (IFN-γ) trended higher with increasing D-dimer, whereas the percentage of lymphocyte (L%) and prealbumin (PAB) trended lower (P&lt;0.01). In addition, the proportions of patients requiring oxygen therapy, glucocorticoid, bronchoscopy, immunoglobulin use, thoracentesis, or ICU admission were significantly higher in the severely elevated group than those in the other two groups (P&lt;0.01). Correlation analysis showed that N%, L%, CRP, LDH, IL-10, length of fever, length of stay, and length of antibiotic therapy had strong correlations with the level of D-dimer.ConclusionsMPP patients with higher levels of D-dimer had more severe clinical manifestations and needed longer duration of treatment, which might be closely related to the severity of lung inflammation after MP infection.

scholarly journals Clinical Characteristics and Risk Factors of Mortality Among Severe COVID-19 Patients

2021 ◽  
Author(s):  
Reham Mohamed Elmorshedy ◽  
Maha Mohamed El-kholy ◽  
Alaa Eldin AbdelMoniem ◽  
Shimaa Abbas Hassan ◽  
Samiaa Hamdy Sadek
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Ground Glass Opacity ◽  
Older Age ◽  
Ground Glass ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Increased Risk ◽  
D Dimer

Abstract Background:The novel corona virus is attacking several millions of people worldwide, resulting in death of almost a million and a half-humans. The rational of the current study was to detect clinical characteristics of severe COVID- 19 patients, and assessment of risk factors for death.Methodology:This retrospective cohort study included all laboratory confirmed COVID-19 patients with severe disease admitted to critical care unit in June and July 2020. All recorded data were collected,which included clinincal, radiological, and laboratory data, in addition to the outcome and duration of ICU stay.Statistical analysis was performed for obtaining descriptive information, comparison between living and dead patients,in addition to regression analysis to identify risk factors for mortality.Results:One hundred and three patients were included in the current study;cough and fever were the most common clinical presentations, and bilateral ground glass opacity was the most common radiological presentation. Patients had elevated values of neutrophils, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), serum ferritin, CRP, and D-dimer, also had longer ICU stay ,with reduced values of lymphocytes, and PaO2/FIO2 ratio. Most of these variables were more exaggerated in dead patients compared to living ones. Older age, lower values of PaO2/FIO2 ratio, and higher values of neutrophils, NLR, and D-dimer were predictors for death.Conclusion: Cough, fever and bilateral ground glass opacity were the most common clinical and radiological presentation of severe COVID 19. Older age, lower value of PaO2/FIO2 ratio, and higher values of D- dimer, neutrophil and NLR were risk factors associated with increased risk of mortality.

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