title: Mycoplasma pneumoniae pneumonia in hospitalized children diagnosed at acute stage by paired sera.
abstract: BACKGROUND
  Mycoplasma pneumoniae (M. pneumoniae) is a frequent cause of respiratory tract infections. However, there is deficient knowledge about the clinical manifestations of M. pneumoniae infection. We described the clinical and laboratory findings of M. pneumoniae pneumonia in hospitalized children who were all diagnosed by a ≥ fourfold increase in antibody titer.
  
  
  METHODS
  M. pneumoniae antibodies were routinely detected in children admitted with acute respiratory infection during a one-year period. The medical history was re-collected from children whose M. pneumoniae antibody titer increased ≥ fourfold at the bedside by a single person, and their frozen paired serum samples were measured again for the M. pneumoniae antibody titer.
  
  
  RESULTS
  Of the 635 children whose sera were detected for the M. pneumoniae antibody, paired sera were obtained from 82 and 29.3% (24/82) showed a ≥ fourfold increase in antibody titer. There were 24 cases, nine boys and 15 girls, aged from two to 14 years, whose second serum samples were taken on day 9 at the earliest after symptom onset; the shortest interval was three days. All children presented with a high fever (≥ 38.5°C) and coughing. Twenty-one had no nasal obstruction or a runny nose, and five had mild headaches which all were associated with the high fever. The disease was comparatively severe if the peak temperature was > 39.5°C. All were diagnosed as having pneumonia through chest X-rays. Four had bilateral or multilobar involvement and their peak temperatures were all ≤ 39.5°C. None of the children had difficulty in breathing and all showed no signs of wheezing.
  
  
  CONCLUSIONS
  The second serum sample could be taken on day 9 at the earliest after symptom onset meant that paired sera could be used for the clinical diagnosis of M. pneumoniae pneumonia in children at the acute stage. M. pneumoniae is a lower respiratory tract pathogen. Extrapulmonary complications were rare and minor in our study. High peak temperature (> 39.5°C) is correlated with the severity of M. pneumoniae pneumonia in children.
authors.affiliation: Department of Infectious Disease, Air Force General Hospital of Chinese People's Liberation Army, Beijing 100142, China. liuchunling100@yahoo.com.cn
authors.forename: Chun-Ling
authors.initials: CL
authors.lastname: Liu
authors.forename: Gui-Qiang
authors.initials: GQ
authors.lastname: Wang
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Hua
authors.initials: H
authors.lastname: Xu
authors.forename: Liang-Ping
authors.initials: LP
authors.lastname: Hu
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: He
authors.forename: Jun-Hua
authors.initials: JH
authors.lastname: Wang
authors.forename: Jun-Hong
authors.initials: JH
authors.lastname: Zhang
authors.forename: Xiao-Yu
authors.initials: XY
authors.lastname: Liu
authors.forename: Ming
authors.initials: M
authors.lastname: Wei
authors.forename: Zhen-Ye
authors.initials: ZY
authors.lastname: Liu
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009177:Mycoplasma pneumoniae / Q000276:immunology; D011019:Pneumonia, Mycoplasma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013902:Radiography, Thoracic
chemical_list: D000907:Antibodies, Bacterial