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Jin P, Han C, Guo W, Xu Y. Mycoplasma pneumoniae pneumonia-associated thromboembolism with plastic bronchitis: a series of five case reports and literature review. Ital J Pediatr 2024; 50:117. [PMID: 38886770 PMCID: PMC11184871 DOI: 10.1186/s13052-024-01690-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 06/09/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Mycoplasma pneumoniae pneumonia is a common respiratory infection among children. However, the occurrence of thromboembolism with plastic bronchitis in association with Mycoplasma pneumoniae pneumonia is extremely rare. This case series presents five cases of children with Mycoplasma pneumoniae pneumonia who developed thromboembolism and plastic bronchitis. The clinical presentation, diagnostic approach, and management strategies are discussed. METHODS A retrospective analysis was conducted on medical records from a pediatric hospital. Patient demographics, clinical features, laboratory findings, imaging results, treatment modalities, and outcomes were collected. RESULTS The patients in our case series presented with varying degrees of respiratory distress, cough, and fever. Imaging studies revealed evidence of thromboembolism based on pulmonary artery occlusion. Bronchial casts were observed by bronchoscopy. Laboratory tests demonstrated elevated D-dimer levels and fibrinogen degradation products. All patients received a combination of low molecular weight heparin anticoagulation and supportive care. CONCLUSION Thromboembolism with plastic bronchitis associated with Mycoplasma pneumoniae pneumonia is a rare but potentially serious complication in children. Prompt recognition and management are crucial for improving patient outcomes. This case series highlights the diverse clinical presentations, diagnostic challenges, and treatment strategies for this unique clinical entity. Further research is needed to better understand the pathogenesis and optimal management of this condition.
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Affiliation(s)
- Peng Jin
- Department of Respiratory Medicine, Tianjin University Children's Hospital (Tianjin Children's Hospital), 238 Longyan Road, Beichen District, Tianjin, 300134, China
- Clinical School of Pediatrics, Tianjin Medical University, Tianjin, China
| | - Chunjiao Han
- Department of Respiratory Medicine, Tianjin University Children's Hospital (Tianjin Children's Hospital), 238 Longyan Road, Beichen District, Tianjin, 300134, China
- Clinical School of Pediatrics, Tianjin Medical University, Tianjin, China
| | - Wei Guo
- Department of Respiratory Medicine, Tianjin University Children's Hospital (Tianjin Children's Hospital), 238 Longyan Road, Beichen District, Tianjin, 300134, China.
| | - Yongsheng Xu
- Department of Respiratory Medicine, Tianjin University Children's Hospital (Tianjin Children's Hospital), 238 Longyan Road, Beichen District, Tianjin, 300134, China.
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Jin P, Zhao LS, Zhang TQ, Di H, Guo W. Establishment of a Mouse Model of Mycoplasma pneumoniae-Induced Plastic Bronchitis. Microorganisms 2024; 12:1132. [PMID: 38930514 PMCID: PMC11205551 DOI: 10.3390/microorganisms12061132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/26/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
Plastic bronchitis (PB) constitutes a life-threatening pulmonary disorder, predominantly attributed to Mycoplasma pneumoniae (MP) infection. The pathogenic mechanisms involved remain largely unexplored, leading to the absence of reliable approaches for early diagnosis and clear treatment. Thus, the present investigation aimed to develop an MP-induced mouse model of PB, thereby enhancing our understanding of this complex condition. In the first stage, healthy BALB/c mice were utilized to investigate the optimal methods for establishing PB. This involved the application of nebulization (15-20 min) and intratracheal administration (6-50 μL) with 2-chloroethyl ethyl sulfide (CEES) concentrations ranging from 4.5% to 7.5%. Subsequently, the MP model was induced by administering an MP solution (2 mL/kg/day, 108 CFU/50 μL) via the intranasal route for a duration of five consecutive days. Ultimately, suitable techniques were employed to induce plastic bronchitis in the MP model. Pathological changes in lung tissue were analyzed, and immunohistochemistry was employed to ascertain the expression levels of vascular endothelial growth factor receptor 3 (VEGFR-3) and the PI3K/AKT/mTOR signaling pathway. The administration of 4.5% CEES via a 6 µL trachea was the optimal approach to establishing a PB model. This method primarily induced neutrophilic inflammation and fibrinous exudate. The MP-infected group manifested symptoms indicative of respiratory infection, including erect hair, oral and nasal secretions, and a decrease in body weight. Furthermore, the pathological score of the MP+CEES group surpassed that of the groups treated with MP or CEES independently. Notably, the MP+CEES group demonstrated significant activation of the VEGFR-3 and PI3K/AKT/mTOR signaling pathways, implying a substantial involvement of lymphatic vessel impairment in this pathology. This study successfully established a mouse model of PB induced by MP using a two-step method. Lymphatic vessel impairment is a pivotal element in the pathogenetic mechanisms underlying this disease entity. This accomplishment will aid in further research into treatment methods for patients with PB caused by MP.
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Affiliation(s)
- Peng Jin
- Department of Respiratory Medicine, Tianjin University Children’s Hospital (Tianjin Children’s Hospital), Tianjin 300134, China; (P.J.)
- Clinical School of Pediatrics, Tianjin Medical University, Tianjin 300070, China
| | - Lin-Sheng Zhao
- Department of Respiratory Medicine, Tianjin University Children’s Hospital (Tianjin Children’s Hospital), Tianjin 300134, China; (P.J.)
| | - Tong-Qiang Zhang
- Department of Respiratory Medicine, Tianjin University Children’s Hospital (Tianjin Children’s Hospital), Tianjin 300134, China; (P.J.)
| | - Han Di
- Department of Respiratory Medicine, Tianjin University Children’s Hospital (Tianjin Children’s Hospital), Tianjin 300134, China; (P.J.)
- Clinical School of Pediatrics, Tianjin Medical University, Tianjin 300070, China
| | - Wei Guo
- Department of Respiratory Medicine, Tianjin University Children’s Hospital (Tianjin Children’s Hospital), Tianjin 300134, China; (P.J.)
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Chen W, Bao W, Shi J, Shi L, Cui J. Investigation into the application of remimazolamin conjunction with low-dose propofolfor pediatricfiberoptic bronchoscopy. Sci Rep 2024; 14:11671. [PMID: 38778051 PMCID: PMC11111447 DOI: 10.1038/s41598-024-62181-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
This study delves into the effectiveness of combining remimazolam with low-dose propofol in pediatric fiberoptic bronchoscopy. Ninety children scheduled for fiberoptic bronchoscopy in our hospital were enrolled as research participants. Based on the intraoperative anesthetic drug regimen, the children were divided into three groups: group R (remimazolam 0.2-0.4 mg/kg), group P (propofol 1-3 mg/kg), and group RP (remimazolam0.2 mg/kg, propofol 0.5 mg/kg). Immediately post-anesthesia, group P exhibited lower blood pressure and heart rate (HR) compared to both group R and group RP (P < 0.05). As bronchoscope approached the glottis and epiglottis, group P continued to display lower blood pressure and HR compared to group R and group RP (P < 0.05). During lavage, group P maintained lower blood pressure and HR compared to both the R and RP groups (P < 0.05). Immediately post-anesthesia, group P demonstrated lower SpO2 compared to the R and RP groups (P < 0.05).During lavage, group P maintained lower SpO2 than group R and group RP (P < 0.05). In comparison with group R and group PR, group P showed shortened induction and recovery times (P < 0.05). The one-time entry success rate into the microscope was higher in group R than in group P, with the RP group showing an intermediate decreased (P < 0.05). Moreover, the cough score in R group was higher than in the P and RP groups (P < 0.05). Furthermore, the satisfaction rates of the RP group exceeded those of the R and P groups (P < 0.05). Remimazolam combined with low-dose propofol effectively balances the strengths and weaknesses of remimazolam and propofol, ensuring more stable hemodynamics, a lower incidence of adverse reactions, and optimal surgical conditions in pediatric fiberoptic bronchoscopy.
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Affiliation(s)
- Wenjing Chen
- Department of Anesthesiology, Hebei Children's Hospital, No.133 Jianhua South Street, Shijiazhuang, 050031, Hebei, China.
| | - Wenjuan Bao
- Department of Anesthesiology, Hebei Children's Hospital, No.133 Jianhua South Street, Shijiazhuang, 050031, Hebei, China
| | - Jing Shi
- Department of Anesthesiology, Hebei Children's Hospital, No.133 Jianhua South Street, Shijiazhuang, 050031, Hebei, China
| | - Lei Shi
- Department of Anesthesiology, Hebei Children's Hospital, No.133 Jianhua South Street, Shijiazhuang, 050031, Hebei, China
| | - Jianli Cui
- Department of Anesthesiology, Hebei Children's Hospital, No.133 Jianhua South Street, Shijiazhuang, 050031, Hebei, China
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Yang L, Zhang Y, Shen C, Lu Z, Hou T, Niu F, Liu R, Ning J, Wang Y. Clinical features and risk factors of plastic bronchitis caused by Mycoplasma pneumoniae pneumonia in children. BMC Pulm Med 2023; 23:468. [PMID: 37996853 PMCID: PMC10668422 DOI: 10.1186/s12890-023-02766-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND We analyzed the clinical characteristics of children with plastic bronchitis (PB) caused by Mycoplasma pneumoniae (MP) and explored its risk factors. METHODS We prospectively analyzed clinical data of children with MP pneumonia (MPP) treated with fiberoptic bronchoscopy (FB). Patients were classified into a PB and non-PB group. General information, clinical manifestations, laboratory tests, results of computed tomography scan, and FB findings were compared between groups. We conducted statistical analysis of risk factors for developing PB. RESULTS Of 1169 children who had MPP and were treated with FB, 133 and 1036 were in the PB and non-PB groups, respectively. There were no significant differences in sex, age, and incident season between groups (P > 0.05). The number of children in the PB group decreased during the COVID-19 pandemic. Compared with children in the non-PB group, those in the PB group had longer duration of hospitalization, increased levels of neutrophil (N), C-reactive protein (CRP), procalcitonin (PCT), D-dimer, lactate dehydrogenase (LDH), alanine transaminase (ALT) and aspartate transaminase (AST); lower levels of lymphocyte (L) and platelet (PLT); and higher incidence of lack of appetite, decreased breath sounds, single lobar infiltrate, pleural effusion, pericardial effusion, mucosal erosion and/or necrosis, and bronchial embolization. L levels and pleural effusion were identified as risk factors in multivariate logistic regression. CONCLUSIONS Children with PB caused by MPP had a strong and local inflammatory response. L levels and pleural effusion were independent risk factors of PB with MPP in children. Our findings will help clinicians identify potential PB in pediatric patients for early and effective intervention.
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Affiliation(s)
- Lei Yang
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China
- Postdoctoral Mobile Station of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250399, China
| | - Yuyan Zhang
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China
| | - Changqing Shen
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China
| | - Zhouhua Lu
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China
| | - Tongshu Hou
- The Second Clinical Medical College, Binzhou Medical University, Yantai, Shandong, 264100, China
| | - Fenghai Niu
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China
| | - Ruihan Liu
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China.
- Postdoctoral Mobile Station of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250399, China.
| | - Jun Ning
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China.
| | - Yuzhong Wang
- Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, 272000, China.
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Liu J, He R, Zhang X, Zhao F, Liu L, Wang H, Zhao S. Clinical features and “early” corticosteroid treatment outcome of pediatric mycoplasma pneumoniae pneumonia. Front Cell Infect Microbiol 2023; 13:1135228. [PMID: 37082710 PMCID: PMC10110948 DOI: 10.3389/fcimb.2023.1135228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 03/10/2023] [Indexed: 04/07/2023] Open
Abstract
BackgroundMany children with mycoplasma pneumoniae (MP) pneumonia (MPP) developed sequelae such as bronchiolitis/bronchitis obliterans (BO). Early corticosteroid therapy might prevent disease progression. This study aimed to use “early” corticosteroid and observe the treatment outcome in patients with MPP.MethodsPatients who had pulmonary infiltrations on chest imaging within 5 days of the disease course and were suspected of having MP infection on admission were enrolled. Among them, patients whose disease course was within 10 days on admission were ultimately enrolled. We analyzed their data including the clinical features, the starting time and dose of corticosteroid therapy, and the treatment outcome. According to chest imaging, we divided patients into two groups (Group A: bronchiolitis-associated lesions or ground-glass opacities; Group B: pulmonary segmental/lobar consolidation).ResultsA total of 210 patients with confirmed MPP were ultimately enrolled. There were 59 patients in Group A and 151 patients in Group B. Patients in Group A were more prone to have allergy histories, hypoxemia, wheezing sound, and wet rales on auscultation than those in Group B. Corticosteroid treatment was initiated between 5 and 10 days of disease onset in all patients and 6–7 days in most patients. Methylprednisolone was prescribed in all patients within 10 days of disease onset, and the highest prescribed dose was at least 2 mg/kg/day. In Group A, methylprednisolone >2 mg/kg/day was prescribed in 22 patients, and among them, 8 patients with diffuse bronchiolitis-associated lesions received high-dose methylprednisolone therapy. After 3 months, lung CT revealed slightly segmental ground-glass opacity in three patients. In Group B, methylprednisolone >2 mg/kg/day was prescribed in 76 patients, and among them, 20 patients with pulmonary lobar consolidation received high-dose methylprednisolone therapy. After 3 months, chest imaging revealed incomplete absorption of pulmonary lesions in seven patients. Among them, five patients with consolidation in more than one pulmonary lobe ultimately had slight BO.ConclusionIn hospitalized patients with MPP, particularly severe MPP, the ideal starting time of corticosteroid treatment might be 5–10 days, preferably 6–7 days, after disease onset. The initial dosage of corticosteroid therapy should be decided according to the severity of the disease. MPP patients with diffuse bronchiolitis-associated lesions/whole lobar consolidation on imaging might require high-dose corticosteroid therapy.
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Affiliation(s)
- Jinrong Liu
- Department of Respiratory Medicine, China National Clinical Research Center of Respiratory Disease, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
- *Correspondence: Shunying Zhao, ; Jinrong Liu,
| | - Ruxuan He
- Department of Respiratory Medicine, China National Clinical Research Center of Respiratory Disease, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Xiaoyan Zhang
- Department of Respiratory Medicine, China National Clinical Research Center of Respiratory Disease, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Fei Zhao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, State Key Laboratory of Infectious Disease Prevention and Control, Beijing, China
| | - Liyong Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, State Key Laboratory of Infectious Disease Prevention and Control, Beijing, China
| | - Heng Wang
- Department of Respiratory Medicine, China National Clinical Research Center of Respiratory Disease, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Shunying Zhao
- Department of Respiratory Medicine, China National Clinical Research Center of Respiratory Disease, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
- *Correspondence: Shunying Zhao, ; Jinrong Liu,
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Huang W, Niu W, Chen H, Jiang W, Fu Y, Li X, Li M, Hua J, Hu C. Development of a nomogram for severe influenza in previously healthy children: a retrospective cohort study. J Int Med Res 2023; 51:3000605231153768. [PMID: 36802862 PMCID: PMC9941605 DOI: 10.1177/03000605231153768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVE We aimed to develop a nomogram to predict the risk of severe influenza in previously healthy children. METHODS In this retrospective cohort study, we reviewed the clinical data of 1135 previously healthy children infected with influenza who were hospitalized in the Children's Hospital of Soochow University between 1 January 2017 and 30 June 2021. Children were randomly assigned in a 7:3 ratio to a training or validation cohort. In the training cohort, univariate and multivariate logistic regression analyses were used to identify risk factors, and a nomogram was established. The validation cohort was used to evaluate the predictive ability of the model. RESULT Wheezing rales, neutrophils, procalcitonin > 0.25 ng/mL, Mycoplasma pneumoniae infection, fever, and albumin were selected as predictors. The areas under the curve were 0.725 (95% CI: 0.686-0.765) and 0.721 (95% CI: 0.659-0.784) for the training and validation cohorts, respectively. The calibration curve showed that the nomogram was well calibrated. CONCLUSION The nomogram may predict the risk of severe influenza in previously healthy children.
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Affiliation(s)
- Wenyun Huang
- Department of Emergency Medicine, Children's Hospital of Soochow University, Suzhou, China,Department of Pediatrics, Suzhou Wujiang District Children’s Hospital (Children's Hospital of Soochow University Wujiang Branch), Suzhou, China
| | - Wensi Niu
- Department of Pediatrics, Suzhou Wujiang District Children’s Hospital (Children's Hospital of Soochow University Wujiang Branch), Suzhou, China
| | - Hongmei Chen
- Department of Emergency Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wujun Jiang
- Department of Pediatrics, Suzhou Wujiang District Children’s Hospital (Children's Hospital of Soochow University Wujiang Branch), Suzhou, China
| | - Yanbing Fu
- Department of Emergency Medicine, Children's Hospital of Soochow University, Suzhou, China,Department of Pediatrics, Suzhou Wujiang District Children’s Hospital (Children's Hospital of Soochow University Wujiang Branch), Suzhou, China
| | - Xiuxiu Li
- Department of Emergency Medicine, Children's Hospital of Soochow University, Suzhou, China,Department of Pediatrics, Suzhou Wujiang District Children’s Hospital (Children's Hospital of Soochow University Wujiang Branch), Suzhou, China
| | - Minglei Li
- Department of Emergency Medicine, Children's Hospital of Soochow University, Suzhou, China,Department of Pediatrics, Suzhou Wujiang District Children’s Hospital (Children's Hospital of Soochow University Wujiang Branch), Suzhou, China
| | - Jun Hua
- Department of Emergency Medicine, Children's Hospital of Soochow University, Suzhou, China,Department of Pediatrics, Suzhou Wujiang District Children’s Hospital (Children's Hospital of Soochow University Wujiang Branch), Suzhou, China,Jun Hua, Children’s Hospital of Soochow University, No. 92 Zhongnan Street, Suzhou Industrial Park, Suzhou, Jiangsu 215025, China.
| | - Chunxia Hu
- Department of Pediatrics, Suzhou Wujiang District Children’s Hospital (Children's Hospital of Soochow University Wujiang Branch), Suzhou, China
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Chen D, Wu P, Liu D, Shen T, Liu S, Zhou H, Wang C. Clinical role of M. pneumoniae typing antibody detected by chemiluminescent immunoassay in the diagnosis of Mycoplasma pneumoniae pneumonia in children. Int Immunopharmacol 2022; 112:109196. [PMID: 36084539 DOI: 10.1016/j.intimp.2022.109196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 07/25/2022] [Accepted: 08/22/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The levels of serum M. pneumoniae typing antibodies in children with community-acquired pneumonia (CAP) were detected by chemiluminescent immunoassay (CLIA) to explore the clinical role of M. pneumoniae typing antibody (MP-IgM, MP-IgG) in M. pneumoniae pneumonia. METHODS A total of 387 Child patients with CAP diagnosed at the Pediatric outpatient department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, were enrolled between January 2020 to December 2021 and divided into M. pneumoniae pneumonia (MPP) group (n = 210) and non-M. pneumoniae pneumonia (NMPP) group (n = 177). Firstly, Clinical data, full blood count (WBC, NEU%, LYM%, MONO%, EOS%, BASO%, RBC, HGB, PLT) and biochemical tests (AST, LDH, ɑ-HBDH, CK, CKMB, CRP, PCT, IL-6) as well as laboratory diagnostic tests (MP-IgM, MP-IgG) were compared between the two groups. Secondly, we assessed the correlation between the average level of M. pneumoniae typing antibody detected by CLIA and the titer of anti-M. pneumoniae antibody (MP-Ab) tested by passive agglutination (PA) method. Thirdly, receiver operating characteristic (ROC) curve for the MP-IgM and MP-IgG was examined to evaluate the value of diagnosing M. pneumoniae pneumonia. Finally, we follow-up 120 cases of MPP group and analysis medication results. RESULTS (1) Mean age, runny nose, expectoration, LYM%, NEU%, HGB, AST, MP-IgM and MP-IgG were statistically significant in the MPP group and NMPP group (all P < 0.05). (2) Correlation analysis showed that MP-IgM average level was linearly associated with MP-Ab titer (R2 = 0.84) and MP-IgG average level was exponentially correlated with MP-Ab titer under 1:640 (R2 = 0.96). (3) The ROC curve of MP-IgM and MP-IgG were significantly different (both P < 0.001). A serum MP-IgM level above 1 S/CO and MP-IgG level above 14.15 AU/mL were significant predictors for M. pneumoniae pneumonia: area under the curve (AUC) of 0.810, 0.815; standard error (SE) of 0.021, 0.022; 95 % confidence interval (CI) of 0.768-0.852, 0.773-0.858; the diagnostic sensitivity of 74.3 %, 62.1 %; and specificity of 72.9 %, 87.0 %; respectively. (4) Of the 120 children with M. pneumoniae pneumonia followed up, 79 (65.8 %) cases took azithromycin and 68 (86.1 %) cases were recovered. CONCLUSIONS A series of our studies shown that, CLIA, speedy and automated clinical examination method, has higher specificity and sensitivity for the quantitative detection of MP-IgM and MP-IgG, playing an important role of early diagnosis as well as prompt intervention to reduces macrolide-resistant strains and sequelae of children with M. pneumoniae pneumonia.
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Affiliation(s)
- Dongmiao Chen
- Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; Laboratory Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
| | - Peiting Wu
- Laboratory Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Duoduo Liu
- Laboratory Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Tingting Shen
- Laboratory Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Shangmin Liu
- Laboratory Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Huayou Zhou
- Department of Blood Transfusion, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
| | - Congrong Wang
- Laboratory Department of Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
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Zhang T, Zheng J, Wang H, Xu Y, Ning J, Cai C. Case Report: Cardiac Multiple Thrombus and Pulmonary Embolism Associated With Mycoplasma Pneumonia Infection in a Child. Front Pediatr 2022; 10:959218. [PMID: 35923784 PMCID: PMC9339891 DOI: 10.3389/fped.2022.959218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
Mycoplasma pneumoniae (MP) is a common pathogen of lower respiratory tract infection in children and adolescents. Some patients with MP infection are self-limiting, while with the increase of severe or refractory Mycoplasma pneumoniae pneumonia (MPP) in recent years, there is a great increase in reports of thromboembolism in multiple organs, including lung, brain, spleen, and peripheral arteries. Cardiac multiple thrombi and pulmonary embolism associated with MP infection have not been reported. The most effective treatment option for cardiac thrombus was surgical resection for fear of thrombus detachment and causing new thromboembolism. Herein, we present a patient with cardiac multiple thrombi and pulmonary embolism in MPP for the first time. In our case, the child recovered after conservative medical treatment, which provides a therapeutic option for children with cardiac multiple thrombi.
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Affiliation(s)
- Tongqiang Zhang
- Department of Respiratory, Tianjin Children’s Hospital (Children’s Hospital of Tianjin University), Tianjin, China
| | - Jiafeng Zheng
- Department of Respiratory, Tianjin Children’s Hospital (Children’s Hospital of Tianjin University), Tianjin, China
| | - Hongbo Wang
- Department of Respiratory, Tianjin Children’s Hospital (Children’s Hospital of Tianjin University), Tianjin, China
| | - Yongsheng Xu
- Department of Respiratory, Tianjin Children’s Hospital (Children’s Hospital of Tianjin University), Tianjin, China
| | - Jing Ning
- Department of Respiratory, Tianjin Children’s Hospital (Children’s Hospital of Tianjin University), Tianjin, China
| | - Chunquan Cai
- Tianjin Institute of Pediatrics, Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin Children’s Hospital (Children’s Hospital of Tianjin University), Tianjin, China
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9
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Zhang X, Yu Y. Severe pediatric Mycoplasma pneumonia as the cause of diffuse alveolar hemorrhage requiring veno-venous extracorporeal membrane oxygenation: A case report. Front Pediatr 2022; 10:925655. [PMID: 36683817 PMCID: PMC9858565 DOI: 10.3389/fped.2022.925655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Diffuse alveolar hemorrhage (DAH) is an acute life-threatening disease often associated with immunocompromised patients and systemic disorders, such as infections, vasculitis, and toxins. Mycoplasma pneumoniae is one of the most common causes of community-acquired pneumonia in children, which rarely causes respiratory failure and fulminant disease; However, a rapid progression may occur in some patients. Mycoplasma pneumonia-associated DAH is rare. CASE PRESENTATION We report a case of severe pediatric mycoplasma pneumonia in an immuno-competent child. This patient's condition progressed rapidly, with severe lung lesions associated with pleural effusion, coagulopathy, diffuse alveolar haemorrhage and severe respiratory distress requiring ventilator and intravenous extracorporeal membrane oxygenation (VV-ECMO) support. She was discharged upon successful treatment. CONCLUSION Diffuse alveolar hemorrhage associated with Mycoplasma pneumoniae in children is very rare, and clinicians should be aware of the potential rapid onset of the disease. Early detection and diagnosis are very important. The main treatment measures include anti-infection and supportive measures such as mechanical ventilation, but as in our case, success with both prone positioning for more than 10 h per day and VV-ECMO was life-saving.
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Affiliation(s)
- Xinjuan Zhang
- Department of Pediatric Intensive Care Unit, Affiliated to Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yanping Yu
- Department of Pediatric Intensive Care Unit, Affiliated to Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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