title: [Early identification of refractory Mycoplasma pneumoniae pneumonia in children].
abstract: OBJECTIVE
  To investigate the clinical indicators for early identification of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children.
  
  
  METHODS
  The clinical data of 142 children with Mycoplasma pneumoniae pneumonia (MPP) between January 2014 and June 2015 were retrospectively studied. Among the 142 children, there were 32 cases of RMPP and 110 cases of non-refractory MPP. The clinical data were compared between the RMPP and non-refractory MPP groups.
  
  
  RESULTS
  The percentage of school-age children in the RMPP group was higher than in the non-refractory MPP group (P<0.05). The mean onset age in the RMPP group was older than the non-refractory MPP group (P<0.05). Steroid was used in 93.8% of RMPP children compared with 7.3% of non-refractory MPP children (P<0.001). Consolidation of lung on chest X-Ray was shown in 87.5% of RMPP children compared with 42.7% of non-refractory MPP children (P<0.001). The incidence of pleural effusion in the RMPP group was higher than in the non-refractory MPP group (P<0.001). The RMPP group had higher percentages of individuals with CRP>40 mg/L and ESR>30 mm/h+LDH>300 IU/L than the non-refractory MPP group (P<0.05).
  
  
  CONCLUSIONS
  RMPP is common in school-age children. Consolidation of lung on chest X-Ray, pleural effusion and increased levels of CRP and ESR+LDH may be helpful to early identification of RMPP in children.
authors.affiliation: Department of Pediatrics, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai 201600, China. yachunli@126.com.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.forename: Ya-Chun
authors.initials: YC
authors.lastname: Li
authors.forename: Lu
authors.initials: L
authors.lastname: Chen
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D011019:Pneumonia, Mycoplasma / Q000097:blood / Q000175:diagnosis*; D011498:Protein Precursors / Q000097:blood; D012189:Retrospective Studies
chemical_list: D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase