[Changes in clinical manifestations of Mycoplasma pneumoniae pneumonia in children older than 3 years during 2000 - 2006 in Hangzhou].
OBJECTIVE
To reveal changes in clinical manifestations of Mycoplasma pneumoniae (Mp) pneumonia in children older than 3 years of age during 2000 - 2006.


METHODS
Totally 288 older children with Mp pneumonia hospitalized in the hospital between 2000 and 2006 were enrolled. Clinical manifestation, chest X-ray and clinical outcomes among three time periods (2000 - 2002, 2003 - 2004, 2005 - 2006) were compared.


RESULTS
(1) Fever and its duration; 281 cases (97.6%) had fever of different duration (median = 7.2 d, 8.5 d, and 11.2 d, respectively) among the time periods, showing statistically significant difference (P < 0.01). (2) Respiratory symptoms: different incidence of wheezing/dyspnea (6.1%, 9.9%, 16.3%), thrilling (6.9%, 11.3%, 19.8%) and chest pain (12.2%, 15.5%, 22.1%) among different time periods had significant difference (χ(2) = 5.87, 11.46, 5.21, P < 0.05). (3) The incidence of extrapulmonary damages (13.0%, 38.0%, 48.8%) among different time periods also had significant difference (χ(2) = 21.27, P < 0.01). (4) Chest X-ray examination showed large area of lesions in most cases; 30.2% of cases seen during 2005 - 2006 were found having pulmonary complications such as pleural effusion or atelectasis. The incidences of pulmonary complications among different time periods had significant difference (P < 0.01). (5) TREATMENT AND OUTCOME: after comparing the efficacy of erythromycin or azithromycin, decline of clinical effectiveness was revealed among different time periods (P < 0.05). The duration of fever after macrolide administration (median = 3.2 d, 4.5 d, 6.2 d, respectively) and hospital stay (median = 7.0 d, 8.7 d, and 11.4 d, respectively) among different time periods showed significant differences (P < 0.05).


CONCLUSIONS
More refractory and severe Mp pneumonia cases appeared during 2000 - 2006 in children older than 3 years of age in Hangzhou, with prolonged fever duration, aggravated respiratory symptoms and more complications and extrapulmonary damages.
Department of Pulomonology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Bing
B
Zhang
Zhi-min
ZM
Chen
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009177:Mycoplasma pneumoniae; D011019:Pneumonia, Mycoplasma / Q000453:epidemiology* / Q000382:microbiology