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Gu H, Li B, Han Y, Yang S, Wang X. Risk factors for suspected pulmonary embolism in children: Complication of Mycoplasma pneumoniae pneumonia. Eur J Radiol 2024; 176:111474. [PMID: 38696918 DOI: 10.1016/j.ejrad.2024.111474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 03/21/2024] [Accepted: 04/16/2024] [Indexed: 05/04/2024]
Abstract
PURPOSE Pulmonary embolism (PE) is not a rare complication of Mycoplasma pneumoniae pneumonia (MPP) in children. We sought to determine the incidence of PE in children with MPP who underwent clinically indicated CT pulmonary angiography (CTPA) and to evaluate the risk factors for PE. METHODS All 106 children with MPP who were clinically suspected of having PE and who underwent CTPA were retrospectively enrolled from June 2018 to December 2021. The clinical features, laboratory data, and radiological parameters were recorded (e.g., lung consolidation involved and the Qanadli score). A Cox proportional hazards model and area under the receiver operating characteristic (ROC) curve were used to evaluate the risk factors and prognostic discriminatory capacity for PE. RESULTS PE was detected in 26 of 106 (24.5 %) children (mean age, 6.2 years ± 3.3 years; 53 boys). Sixteen of the 26 (61.5 %) children with PE were boys. The mean age of the children with PE was 8.1 ± 2.9 years, and the mean Qanadli score was 15.3 ± 10.2. Children with PE had higher D-dimer levels (9.3 ± 7.1 mg/Lvs. 3.6 ± 3.8 mg/L) and a greater frequency of lung lobe consolidation (25 (96.2 %) vs. 64 (80.0 %)) (all P < 0.05). For children with MPP, age (hazard ratio (HR) = 1.96 (95 % CI1.04, 3.71; P = 0.037), D-dimer level (HR = 1.52, 95 % CI: 1.03, 2.24; P = 0.029), and bilateral lung consolidation (HR = 2.41, 95 % CI: 1.03, 5.58; P = 0.043) were found to be independent predictors of PE. CONCLUSION Clinical and CT radiological predictors could be used to predict PE in children with MPP. The use of risk factor assessment as a tool has the potential to guide more appropriate use of CTPA in children.
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Affiliation(s)
- Hui Gu
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, #324, Jingwu Road, Jinan, Shandong 250021, China
| | - Bowen Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, #324, Jingwu Road, Jinan, Shandong 250021, China
| | - Yicheng Han
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, #324, Jingwu Road, Jinan, Shandong 250021, China
| | - Shifeng Yang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, #324, Jingwu Road, Jinan, Shandong 250021, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, #324, Jingwu Road, Jinan, Shandong 250021, China.
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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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Yu Y, Jin X, Zhang X, Shen Y. Pulmonary Thrombotic Complication of Mycoplasma pneumoniae Pneumonia in Chinese Children: Clinical Feature and Risk Factor Analysis. Pediatr Infect Dis J 2024; 43:505-510. [PMID: 38359345 DOI: 10.1097/inf.0000000000004287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND Thrombotic disease is a rare but severe complication of Mycoplasma pneumoniae pneumonia in children, with pulmonary thrombosis (PT) being the most frequent type. This study aims to describe the clinical features of pediatric severe Mycoplasma pneumoniae pneumonia (SMPP) patients with PT, and to identify risk factors predictive of PT development in this population. METHODS We retrospectively enrolled 60 children with SMPP complicated by PT who were admitted to Children's Hospital Affiliated to Zhengzhou University from January 2019 to October 2023. We reviewed their demographic data, laboratory tests and imaging examinations to describe their clinical features. We used multivariate logistic regression analysis to identify significant risk factors for PT in SMPP. RESULTS The PT group exhibited higher incidences of chest pain, hemoptysis, inflammation and elevated D-dimer levels, as well as more severe pulmonary damage and transaminitis complication, compared to the non-PT group. The left pulmonary artery was the predominant location of PT in SMPP children. A multivariate analysis revealed that C-reactive protein (CRP) and D-dimer were significant predictors of PT in SMPP patients, with odds ratios of 1.10 and 3.37, respectively. The optimal cutoff values of CRP and D-dimer for predicting PT in SMPP were 76.73 mg/L and 3.98 µg/mL, respectively. CONCLUSIONS In SMPP, CRP >76.73 mg/L and D-dimer >3.98 µg/mL are independent predictors of PT. These findings suggest that SMPP-induced excessive inflammation may contribute to PT pathogenesis. Early and intensive anticoagulant, anti-inflammatory and antimycoplasma therapy may improve the disease course and prognosis.
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Affiliation(s)
- Yanjuan Yu
- From the Respiratory Department, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou
| | - Xiuhong Jin
- From the Respiratory Department, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou
| | - Xiangfeng Zhang
- From the Respiratory Department, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou
| | - Yuelin Shen
- Respiratory Department II, National Clinical Research Center for Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Wang C, Li L, Xiao G, Chen Y, Wang Y, Chen Z, Zhou Y. Characteristics and Outcomes of Mycoplasma Pneumoniae Pneumonia Associated with Pulmonary Embolism and Necrotizing Pneumonia in Children. Infect Drug Resist 2024; 17:1961-1969. [PMID: 38779350 PMCID: PMC11108758 DOI: 10.2147/idr.s459626] [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] [Received: 01/17/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Purpose To explore the clinical characteristics, treatment, and long-term prognosis of mycoplasma pneumoniae pneumonia (MPP) combined with pulmonary embolism (PE) in children. Patients and Methods The medical records of 16 children who were diagnosed with MPP associated with PE between January 2016 and January 2023 at Children's Hospital, Zhejiang University School of Medicine were retrospectively reviewed. Results The average age patients were 8.24 ± 1.99 years. All cases were diagnosed with refractory mycoplasma pneumoniae pneumonia (RMPP) and presented complications in the form of necrotizing pneumonia (NP). The main symptoms observed were cough and fever (n = 16, 100%), chest pain (n = 8, 50%), dyspnea (n = 8, 50%), and hemoptysis (n = 4, 25%). In these cases, 12 patients had involvement of the pulmonary artery, 3 patients experienced issues with the pulmonary vein, and 1 patient had simultaneous involvement of both the pulmonary artery and pulmonary vein. Among the 12 pulmonary artery embolism cases, 6 involved the right pulmonary artery, 4 involved the left pulmonary artery, and 2 involved both the right and left pulmonary arteries. The mean D-dimer level was 8.50 ± 4.76 mg/L. All patients received anticoagulant therapy, and after treatment, there was a significant improvement in their symptoms and lung lesions. Conclusion Children with RMPP, chest pain, hemoptysis, and elevated D-dimer levels should be closely monitored for the potential development of PE. The co-occurrence of MPP and PE often involves the presence of NP. In cases of confirmed PE, anticoagulation therapy may be a suitable consideration. PE and NP resulting from MPP generally had a favorable overall prognosis.
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Affiliation(s)
- Chenlu Wang
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
- National Clinical Research Center for Child Health, Hangzhou, Zhejiang, People’s Republic of China
| | - Lanxin Li
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
- National Clinical Research Center for Child Health, Hangzhou, Zhejiang, People’s Republic of China
| | - Gang Xiao
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
- National Clinical Research Center for Child Health, Hangzhou, Zhejiang, People’s Republic of China
- Department of Pediatrics, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, People’s Republic of China
| | - Yuanyuan Chen
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
- National Clinical Research Center for Child Health, Hangzhou, Zhejiang, People’s Republic of China
| | - Yingshuo Wang
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
- National Clinical Research Center for Child Health, Hangzhou, Zhejiang, People’s Republic of China
| | - Zhimin Chen
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
- National Clinical Research Center for Child Health, Hangzhou, Zhejiang, People’s Republic of China
| | - Yunlian Zhou
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
- National Clinical Research Center for Child Health, Hangzhou, Zhejiang, People’s Republic of China
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谢 利, 冯 特, 郭 燕, 张 玉, 李 远, 张 万. [Risk factors for embolism in children with refractory Mycoplasmapneumoniae pneumonia and construction of a nomogram model for prediction of embolism]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2024; 26:486-492. [PMID: 38802909 PMCID: PMC11135069 DOI: 10.7499/j.issn.1008-8830.2311146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/20/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES To study the risk factors for embolism in children with refractory Mycoplasma pneumoniae pneumonia (RMPP) and to construct a nomogram model for prediction of embolism. METHODS This retrospective study included 175 children diagnosed with RMPP at Children's Hospital Affiliated toZhengzhou University from January 2019 to October 2023. They were divided into two groups based on the presence of embolism: the embolism group (n=62) and the non-embolism group (n=113). Multivariate logistic regression analysis was used to screen for risk factors of embolism in children with RMPP, and the R software was applied to construct the nomogram model for prediction of embolism. RESULTS Multivariate logistic regression analysis indicated that higher levels of D-dimer, interleukin-6 (IL-6) and neutrophil to lymphocyte ratio (NLR), lung necrosis, and pleural effusion were risk factors for embolism in children with RMPP (P<0.05). The area under the curve of the nomogram model for prediction of embolism constructed based on the aforementioned risk factors was 0.912 (95%CI: 0.871-0.952, P<0.05). The Hosmer-Lemeshow goodness-of-fit test showed that the model had a good fit with the actual situation (P<0.05). Calibration and decision curve analysis indicated that the model had high predictive efficacy and clinical applicability. CONCLUSIONS Higher levels of D-dimer, IL-6 and NLR, lung necrosis, and pleural effusion are risk factors for embolism in children with RMPP. The nomogram model based on these risk factors has high clinical value for predicting embolism in children with RMPP.
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Fu Y, Zhang TQ, Dong CJ, Xu YS, Dong HQ, Ning J. Clinical characteristics of 14 pediatric mycoplasma pneumoniae pneumonia associated thrombosis: a retrospective study. BMC Cardiovasc Disord 2023; 23:1. [PMID: 36600223 DOI: 10.1186/s12872-022-03030-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/26/2022] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the clinical characteristics and long-term prognosis of mycoplasma pneumoniae pneumonia (MPP)-associated thrombosis and to gain a better understanding of the diagnosis and treatment of the disease. METHODS The medical records of 14 children with MPP-associated thrombosis between January 2016 and April 2020 were retrospectively reviewed at the Tianjin Children's Hospital. RESULTS The ages of the patients ranged from 3 to 12 years old. Among the 14 cases, there were five cases of pulmonary embolism, two cases of cerebral infarction, one case of splenic infarction, one case of cardiac embolism, two cases of cardiac embolism with comorbid pulmonary embolism, one case of internal carotid artery and pulmonary embolism, one case of combined internal carotid artery and the cerebral infarction, and one case combined cardiac embolism and lower limb artery embolism. All cases had elevated D-dimer levels. After thrombolysis and anticoagulation therapy, three cases with cerebral embolism still suffered from neurological sequelae. In contrast, the remaining cases did not develop complications. CONCLUSION MPP-associated thrombosis can occur in any vessel of the body. Thrombosis-associated symptoms may be complex and non-specific. Elevated D-dimer levels in a child with refractory mycoplasma pneumoniae pneumonia should raise suspicion of thrombosis. The long-term prognosis of thrombosis was favorable after the timely administration of anticoagulant therapy.
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Affiliation(s)
- Y Fu
- Department of Respiratory Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - T Q Zhang
- Department of Respiratory Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - C J Dong
- Department of Respiratory Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - Y S Xu
- Department of Respiratory Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - H Q Dong
- Department of Respiratory Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - J Ning
- Department of Respiratory Medicine, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China.
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Han C, Zhang T, Zheng J, Jin P, Zhang Q, Guo W, Xu Y. Analysis of the risk factors and clinical features of Mycoplasma pneumoniae pneumonia with embolism in children: a retrospective study. Ital J Pediatr 2022; 48:153. [PMID: 35987653 PMCID: PMC9391649 DOI: 10.1186/s13052-022-01344-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background Mycoplasmapneumoniae pneumonia (MPP) is a prevalent disease in community-acquired pneumonia among children. However, in addition to respiratory manifestations, it may also develop extra-pulmonary complications. Embolism is one of the uncommon extra-respiratory manifestations prone to severe sequelae and even death. This study aims to analyze the clinical features of MPP with embolism in children, and explore the associated risk factors of embolism in MPP patients. Methods A retrospective case–control analysis was performed on 48 children with MPP admitted to our hospital wards between January 2010 and December 2021. Embolism group comprised children with embolism by CTA or MRA results, whereas the non-embolism group comprised children with clinical suspicion of embolism but negative diagnostic imaging support. The clinical features, laboratory findings and imaging were analyzed to explore the risk factors for embolism in children with MPP. Results A total of 48 children with MPP were enrolled in the study (16 cases and 32 controls). In the embolism group, 10 patients (62.5%) had pulmonary embolism, 3 patients (18.75%) presented ventricle embolism, 2 patients (12.5%) presented cerebral and carotid artery embolism, one patient (6.25%) had a cerebral embolism, limb, and spleen, respectively. The univariate analysis revealed the maximum body temperature (Tmax), CRP, D-dimer (closest to CTA/MRA), the percentage of neutrophils (N%), pulmonary consolidation (⩾ 2/3 lobe), pleural effusion and atelectasis have significant differences between the embolism group and non-embolism group (P < 0.05). Multivariate logistic regression analysis showed that D-dimer (closest to CTA/MRA) > 3.55 mg/L [OR = 1.255 (95% CI: 1.025—1.537), P < 0.05], pulmonary consolidation (⩾ 2/3 lobe) [OR = 8.050 (95% CI: 1.341—48.327), P < 0.05], and pleural effusion [OR = 25.321 (95% CI: 2.738—234.205), P < 0.01] were independent risk factors for embolism in children with MPP. Conclusion In conclusion, MPP with embolism patients have more D-dimer values and severe radiologic manifestations.
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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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Yan Q, Niu W, Jiang W, Hao C, Chen M, Hua J. Risk factors for delayed radiographic resolution in children with refractory Mycoplasma pneumoniae pneumonia. J Int Med Res 2021; 49:3000605211015579. [PMID: 34034536 PMCID: PMC8161875 DOI: 10.1177/03000605211015579] [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: 10/30/2022] Open
Abstract
OBJECTIVE To determine the risk factors for delayed radiographic resolution in children with refractory Mycoplasma pneumoniae pneumonia (RMPP) and explore the most suitable time for interventional bronchoscopy. METHODS This retrospective study involved 142 children with RMPP who were admitted to our hospital from 1 January 2015 to 31 December 2017. They were divided into a common resolution group and a delayed resolution group based on their chest radiograph series. RESULTS Among the 142 patients, 67 showed common resolution on chest radiographs and 75 showed delayed resolution. Independent risk factors for delayed resolution were a clinical course of ≥11.5 days before the performance of interventional bronchoscopy, mucus plug formation, corticosteroid resistance, and atelectasis. When bronchoscopy was performed before the disease had been present for <11.5 days, the length of hospitalization, total fever duration, and duration of time until disappearance of coughing were shorter than those in children who underwent bronchoscopy after the disease had been present for ≥11.5 days. CONCLUSIONS Corticosteroid resistance, the time to interventional bronchoscopy, atelectasis, and mucus plug formation were associated with delayed resolution on chest radiographs. Performance of interventional bronchoscopy before the clinical course has reached 11.5 days may help alleviate clinical symptoms and improve radiographic resolution.
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Affiliation(s)
- Qiuli Yan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.,Children's Hospital of Wujiang District, Suzhou, China
| | - Wensi Niu
- Children's Hospital of Wujiang District, Suzhou, China
| | - Wujun Jiang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Chuangli Hao
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Meiyuan Chen
- Children's Hospital of Wujiang District, Suzhou, China
| | - Jun Hua
- Children's Hospital of Wujiang District, Suzhou, China
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