Difference of clinical features in childhood Mycoplasma pneumoniae pneumonia.
BACKGROUND
M. pneumoniae pneumonia (MP) has been reported in 10-40% of community-acquired pneumonia cases. We aimed to evaluate the difference of clinical features in children with MP, according to their age and chest radiographic patterns.


METHODS
The diagnosis of MP was made by examinations at both admission and discharge and by two serologic tests: the indirect microparticle agglutinin assay (>or=1:40) and the cold agglutinins titer (>or=1:32). A total of 191 children with MP were grouped by age: <or=2 years of age (29 patients), 3-5 years of age (81 patients), and >or=6 years of age (81 patients). They were also grouped by pneumonia pattern: bronchopneumonia group (96 patients) and segmental/lobar pneumonia group (95 patients).


RESULTS
Eighty-six patients (45%) were seroconverters, and the others showed increased antibody titers during hospitalization. Among the three age groups, the oldest children showed the longest duration of fever, highest C-reactive protein (CRP) values, and the most severe pneumonia pattern. The patients with segmental/lobar pneumonia were older and had longer fever duration and lower white blood cell (WBC) and lymphocyte counts, compared with those with bronchopneumonia. The patient group with the most severe pulmonary lesions had the most prolonged fever, highest CRP, highest rate of seroconverters, and lowest lymphocyte counts. Thrombocytosis was observed in 8% of patients at admission, but in 33% of patients at discharge.


CONCLUSIONS
In MP, older children had more prolonged fever and more severe pulmonary lesions. The severity of pulmonary lesions was associated with the absence of diagnostic IgM antibodies at presentation and lymphocyte count. Short-term paired IgM serologic test may be mandatory for early and definitive diagnosis of MP.
Youn
You-Sook
YS
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea. leekyungyil@catholic.ac.kr.
Lee
Kyung-Yil
KY
Hwang
Ja-Young
JY
Rhim
Jung-Woo
JW
Kang
Jin-Han
JH
Lee
Joon-Sung
JS
Kim
Ji-Chang
JC
D000293:Adolescent; D000367:Age Factors; D000372:Agglutination Tests; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009177:Mycoplasma pneumoniae / Q000276:immunology / Q000302:isolation & purification; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis* / Q000473:pathology
D000907:Antibodies, Bacterial