scholarly journals Unresolved atelectasis in refractory Mycoplasma pneumoniae pneumonia: Predictive factors and the influence of corticosteroids and bronchoscopy lavage therapy

2020 ◽  
Author(s):  
Jianhua Liu ◽  
Jinrong Liu ◽  
Bei Wang ◽  
Yajing Liu ◽  
Chengsong Zhao ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Early Recognition ◽  
Multiple Logistic Regression Analysis ◽  
Disease Onset ◽  
Chest Imaging ◽  
Corticosteroid Administration ◽  
Starting Time ◽  
Group A ◽  
The Impact ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract Background Unresolved atelectasis occurs in some children with refractory mycoplasma pneumoniae pneumonia (RMPP). The aim was to analyze factors predicting unresolved atelectasis in RMPP and the impact of corticosteroids and bronchoscopy lavage therapy (BLT) on developing atelectasis.Methods We retrospectively analyzed data for 230 pediatric RMPP from January 2013 to June 2017 in Beijing Children’s Hospital. In this study, we diagnosed RMPP when patients' clinical and radiological findings deteriorated after 7 days of macrolide therapy, peripheral blood C-reactive protein (CRP) was higher than 40mg/L, and chest imaging showed consolidation with high density > 1/2 pulmonary lobe. We divided patients into two groups according to the presence/absence of atelectasis on chest imaging after a 6-month follow-up. We calculated the predictive value of fever duration, levels of CRP and lactate dehydrogenase (LDH), and the size of lobe consolidation, regarding atelectasis. Additionally, we compared the starting time and dosage of corticosteroids and the starting time of BLT between the two groups.Results Ninety-five patients developed atelectasis (atelectasis group/group A), and 135 patients did not (non-atelectasis group/group NA). Chest imaging showed > 2/3 pulmonary lobe consolidation in 93.7% of patients in group A and 54.1% of patients in group NA. Multiple logistic regression analysis showed that fever duration, CRP and LDH levels, and lobe consolidation were related to developing atelectasis. Areas under the curve revealed that CRP ≥ 137 mg/L had 82.11% sensitivity and 80.07% specificity, and LDH ≥ 471 IU/L had 62.65% sensitivity and 60.31% specificity to predict atelectasis. Fewer patients receiving corticosteroids and BLT within 10 days after illness onset developed atelectasis.Conclusions Fever duration>10 days, CRP and LDH levels, and lobe consolidation are risk factors for developing atelectasis in RMPP. CRP ≥ 137 mg/L, LDH ≥ 471 IU/L, and >2/3 pulmonary lobe consolidation were significant predictors of atelectasis, which can aid in early recognition. Corticosteroid administration and subsequent BLT within 10 days of the disease onset, and increased corticosteroid dosage may help reduce the incidence of atelectasis in these RMPP patients.

scholarly journals Bronchoscopic Features and Correlative Factor Analysis of Severe Mycoplasma pneumoniae Pneumonia in Children.

2021 ◽  
Author(s):  
haiming yang ◽  
Gan Li ◽  
Xicheng Liu
Keyword(s):  
Factor Analysis ◽  
Incidence Rate ◽  
Mycoplasma Pneumoniae ◽  
Clinical Evaluation ◽  
Medical Records ◽  
Disease Onset ◽  
Acute Stage ◽  
Recovery Stage ◽  
Subacute Stage ◽  
Mycoplasma Pneumoniae Pneumonia

Objectives: We aimed to determine the bronchoscopic features of children with severe Mycoplasma pneumoniae pneumonia (SMPP), and correlation with obliterative bronchitis (OB), so as to help early clinical evaluation and treatment of pediatric SMPP. Methods: 213 pediatric SMPP cases admitted to Beijing Children’s Hospital were included. Medical records and bronchoscopic manifestations at different SMPP stages were retrospectively analyzed . Results: Of 213 acute-stage pediatric SMPP patients, bronchoscopy revealed 22 cases (10.3%) with subacute-stage or recovery-stage OB, for an OB incidence rate in cases with mucous embolus of 48.8% (22/47), a significantly higher rate than the rate without mucous embolus (0/166, 0%) (P < 0.001). Notably, the OB incidence rate for children undergoing bronchoscopy within 10 days (9/142, 6.3%) of SMPP onset was significantly lower than in children undergoing bronchoscopy 10 days post-disease onset (13/71, 76.5%) (P < 0.007). Conclusions: In pediatric SMPP patients, airway mucus and debris from epithelial necrosis and exfoliation can block airway subbranches, readily leading to OB.

scholarly journals Risk factors of 90-day rehospitalization following discharge of pediatric patients hospitalized with mycoplasma Pneumoniae pneumonia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Le Wang ◽  
Zhishan Feng ◽  
Jinfeng Shuai ◽  
Jianhua Liu ◽  
Guixia Li
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Body Temperature ◽  
Mycoplasma Pneumoniae ◽  
Influenza A ◽  
Pediatric Patients ◽  
Clinical Laboratory ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract Background Among pediatric patients hospitalized for Mycoplasma pneumoniae pneumonia (MPP), the risk factors for 90-day readmission after discharge is undefined. Methods We conducted a retrospective observational study of patients <14 years of age who were discharged with a diagnosis of MPP between January 2016 and February 2017. We collected clinical, laboratory and radiographic variables at the time of initial admission. We assessed pneumonia-related readmission within 90-day after discharge. Risk factors independently associated with rehospitalization were identified using multiple logistic regression models. Results Of the 424 MPP hospitalizations, 48 (11.3%) were readmitted within 90 days and were mainly diagnosed with pneumonia. Patients with younger age or coinfection with influenza A were more likely to be readmitted. In addition, compared with children without readmission, the readmission ones showed different clinical and laboratory characteristics at the index hospital admission. Multiple logistic regression analysis identified age (OR 0.815, 95%CI 0.706–0.940) and body temperature (OR 0.659, 95%CI 0.518–0.839) were significantly associated with lower risk of 90-day readmission. Coinfection with influenza was independently associated with a greater likelihood of 90-day readmission (OR 4.746, 95%CI 1.191–18.913). Conclusions Readmission after MPP are common and is related to patients’ age, body temperature and influenza A coinfection during initial hospital stay, indicating potential targets could be noticed to reduce the rehospitalization after pediatric MPP.

scholarly journals Prevalence and clinical characteristics of septicemia in children with Mycoplasma pneumoniae pneumonia

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110217
Author(s):  
Li Liu ◽  
Shobha Maharjan ◽  
Jia-Liang Sun ◽  
Yan-Chun Li ◽  
Huan-Ji Cheng
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Clinical Characteristics ◽  
Healthy Children ◽  
Healthy Controls ◽  
Clinical Value ◽  
Peripheral Blood Mononuclear ◽  
Physical Examinations ◽  
Polymerase Chain ◽  
The Impact ◽  
Mycoplasma Pneumoniae Pneumonia

Background Mycoplasma pneumoniae (MP) pneumonia in children can be challenging to treat, and the impact of MP blood infection is unclear. The present study aims to determine the prevalence and clinical characteristics of MP septicemia among pediatric patients. Methods Children hospitalized at our center for MP pneumonia between October 2017 and June 2018 were included. Healthy controls visiting our outpatient clinic for regular physical examinations were also enrolled. MP was detected by real-time polymerase chain reaction (qPCR) analysis of plasma and peripheral blood mononuclear cell (PBMC) samples. Results Sixty-one children with MP pneumonia and 30 healthy children were included. Among children with MP infection, 31 (50.8%) were positive for MP by qPCR (19 in plasma samples, 8 in PBMC samples, and 4 in both). All healthy controls were negative for MP by qPCR. Conclusions The prevalence of MP septicemia in children with MP pneumonia is moderate. However, detection of MP in blood samples may have limited clinical value for guiding treatment.

scholarly journals Mycoplasma pneumoniae​ pneumonia associated thrombosis at Beijing Children’s Hospital

2019 ◽  
Author(s):  
Jinrong Liu ◽  
Ruxuan He ◽  
Runhui Wu ◽  
Bei Wang ◽  
Hui Xu ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Anticoagulant Therapy ◽  
Disease Onset ◽  
The Body ◽  
Common Symptom ◽  
Pulmonary Consolidation ◽  
Long Term Prognosis ◽  
Mycoplasma Pneumoniae Pneumonia ◽  
D Dimer

Abstract Background: With the increase of awareness of mycoplasma pneumoniae pneumonia (MPP), we found thrombosis in severe MPP (SMPP) was not rare. The aim of the study was to investigate the clinical characteristics, treatment, and long-term prognosis of MPP-associated thrombosis. Methods: Data from 43 cases of MPP-associated thrombosis were retrospectively analyzed. The results of blood coagulation studies and autoimmune antibody and thrombophilia screening were analyzed. The results of contrast-enhanced lung computed tomography, echocardiography, and blood vessel ultrasonography were analyzed, as were treatment outcomes. Results: Forty-two patients were diagnosed with SMPP. The mean D-dimer level was 11.1 ± 12.4 mg/L. Anticardiolipin-IgM was positive in 60.0% of patients, β2-glycoprotein-IgM in 64.0%, and lupus anticoagulant in 42.1%. Chest imaging revealed pulmonary consolidation with lobe distribution in all patients (2/3–1 lobe in 10 patients, > 1 lobe in 29 patients). Thrombosis can occur in a vessel of any part of the body. It can be initially detected as late as 31 days after disease onset. Thrombosis in the brain and abdomen can occur early, at 5 days after disease onset. Pulmonary vessels were the most commonly involved sites in the current study, and accordingly chest pain was the most common symptom (32.6%), followed by neurological symptoms (14.0%) and abdominal pain (9.3%). Thirty-five percent of patients were asymptomatic with regard to thrombosis. All patients underwent anticoagulant therapy, and thrombus absorption took > 3 months in most patients. All patients were followed until October 2019, at which time 41 were asymptomatic and 2 had mild recurrent cough. Conclusions: SMPP with pulmonary consolidation (> 2/3 lobe) was the most strongly associated risk factor for thrombosis. Thrombosis-associated symptoms may be subtle, even absent. Elevated D-dimer, specifically > 11.1 mg/L, would assist in the early diagnosis of thrombosis. The long-term prognosis of thrombosis was good after timely administration of anticoagulant therapy.

scholarly journals Mycoplasma pneumoniae​ pneumonia associated thrombosis at Beijing Children’s Hospital

2020 ◽  
Author(s):  
Jinrong Liu ◽  
Ruxuan He ◽  
Runhui Wu ◽  
Bei Wang ◽  
Hui Xu ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Anticoagulant Therapy ◽  
Disease Onset ◽  
Children's Hospital ◽  
Pulmonary Consolidation ◽  
Children’S Hospital ◽  
Long Term Prognosis ◽  
Mycoplasma Pneumoniae Pneumonia ◽  
D Dimer

Abstract Background: With the increase of awareness of mycoplasma pneumoniae pneumonia (MPP), we found thrombosis in severe MPP (SMPP) was not rare. The aim of the study was to investigate the clinical characteristics, treatment, and long-term prognosis of MPP-associated thrombosis. Methods: We retrospectively reviewed the medical records of 43 children with MPP-associated thrombosis between January 2013 and June 2019 at Beijing Children’s Hospital. The results of blood coagulation studies, autoimmune antibody, thrombophilia screening, contrast-enhanced lung computed tomography, echocardiography, and blood vessel ultrasonography were analyzed, as were treatment outcomes. Results: Forty-two patients were diagnosed with SMPP. D-dimer was higher than 5.0 mg/L in 58.1% (25/43) of patients. The mean D-dimer level was 11.1 ± 12.4 mg/L. Anticardiolipin-IgM was positive in 60.0% of patients, β2-glycoprotein-IgM in 64.0%, and lupus anticoagulant in 42.1%. Chest imaging revealed pulmonary consolidation with lobe distribution in all patients (2/3–1 lobe in 10 patients, > 1 lobe in 29 patients). In our experience, thrombosis can occur in a vessel of any part of the body, and it can be initially detected as late as 31 days after disease onset. Thrombosis in the brain and abdomen can occur early, at 5 days after disease onset. Pulmonary vessels were the most commonly involved sites in the current study, and accordingly chest pain was the most common symptom (32.6%), followed by neurological symptoms (14.0%) and abdominal pain (9.3%). Thirty-five percent of patients were asymptomatic with regard to thrombosis. All patients underwent anticoagulant therapy, and thrombus absorption took > 3 months in most patients. All patients were followed until October 2019, at which time 41 were asymptomatic and 2 had mild recurrent cough. Conclusions: SMPP with pulmonary consolidation (> 2/3 lobe) was the most strongly associated risk factor for thrombosis. Thrombosis-associated symptoms may be subtle, even absent. Elevated D-dimer, specifically > 11.1 mg/L (even > 5.0mg/L), would assist in the early diagnosis of thrombosis. The long-term prognosis of thrombosis was good after timely administration of anticoagulant therapy.

Clinical, radiographic and hematological characteristics of Mycoplasma pneumoniae pneumonia

2010 ◽  
Vol 0 (0) ◽  
Author(s):  
Let&iacute;cia Alves Vervloet ◽  
Paulo Augusto Moreira Camargos ◽  
Dami&atilde;o Ranulfo Fernandes Soares ◽  
Gabriel Ant&ocirc;nio de Oliveira ◽  
Jan&uacute;ncio Nunes de Oliveira
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Mycoplasma Pneumoniae Pneumonia

Bilateral periorbital necrotising fasciitis associated with invasive group: a Streptococcus infection

2020 ◽  
Vol 13 (12) ◽  
pp. e236800
Author(s):  
Grace Anne McCabe ◽  
Thomas Hardy ◽  
Thomas Gordon Campbell
Keyword(s):  
Group A Streptococcus ◽  
Early Recognition ◽  
Skin Grafting ◽  
Final Diagnosis ◽  
Necrotising Fasciitis ◽  
Invasive Group ◽  
Group A ◽  
Tissue Microscopy ◽  
Periorbital Swelling ◽  
Multidisciplinary Teamwork

A previously independent 56-year-old immunocompetent woman presented with septic shock in the setting of periorbital swelling and diffuse infiltrates on chest imaging. Blood cultures were positive for growth of group A Streptococcus (GAS). Broad spectrum antimicrobials were initiated with the inclusion of the antitoxin agent clindamycin. Necrosis of periorbital tissue was noted and surgical consultation was obtained. Débridement of both eyelids with skin grafting was performed. GAS was isolated from wound cultures and also observed on periorbital tissue microscopy. The final diagnosis was bilateral periorbital necrotising fasciitis (PONF) associated with invasive GAS infection. The patient had a prolonged intensive care unit course with input from multiple specialist teams. This case demonstrates the importance of early recognition and treatment of PONF, the profound systemic morbidity caused by these infections, and illustrates successful multidisciplinary teamwork.

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