Mycoplasma pneumonia in young children, 2-5 years of age.
BACKGROUND
Mycoplasma pneumoniae is one of the most common causes of childhood community-acquired pneumonia (CAP), particularly in school-age children. Information regarding this infection in pre-school age children is lacking.


OBJECTIVE
To determine the prevalence of M. pneumoniae in young children aged under 5 years with CAP.


METHODS
This prospective study was conducted at Queen Sirikit National Institute of Child Health (QSNICH), Bangkok, Thailand between December 2001 and November 2002. We enrolled children aged 2 to 5 years with a clinical and radiological diagnosis of CAP. Acute and convalescent sera were collected and measured by using a particle agglutination test. Polymerase chain reaction (PCR) assay for M. pneumoniae was detected from nasopharyngeal secretions. Criteria for diagnosis were defined as > or = 4-found rising of mycoplasma antibody or titer > or = 1:160 with positive PCR.


RESULTS
Thirteen out of 113 CAP patients were diagnosed as mycoplasma pneumonia. Three of them were diagnosed by > or = 4-fold rising of mycoplasma antibody while another 10 patients were diagnosed by mycoplasma titer > or = 1:160 with positive PCR for M. pneumoniae. Clinical symptoms and signs of these 13 mycoplasma pneumonia in young patients were fever (85%), cough (92%), dyspnea (85%), diarrhea (15%), rales (85%), wheezing or rhonchi (46%), and skin rash (15%). Leucocytosis (wbc > 15,000/cumm) was found in 46%. Chest x-rays revealed interstitial infiltration (71%), patchy infiltration (29%) and no pleural effusion was detected. Choices of antibiotic were erythromycin (31%), beta lactam antibiotics (61%), and antibiotic was not prescribed in one patient (8%). Sixty-nine percent of the patients improved, while 31% did not, possibly due to the use of beta lactam antibiotics, or non use of antibiotics.


CONCLUSIONS
Mycopalsma pneumonia is not uncommon in children aged 2-5 years with CAP. Clinical signs, symptoms and radiological findings are non-specific and cannot be differentiated from other causes of CAP.
Bunnag
Thanyanat
T
Department of Pediatrics, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Bangkok, Thailand. thanyanant@childrenhospital.go.th
Lochindarat
Sorasak
S
Srisan
Panida
P
Jetanachai
Pravit
P
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011446:Prospective Studies; D013785:Thailand / Q000453:epidemiology
D000900:Anti-Bacterial Agents