Analysis of Clinical Features on 55 Adult Mycoplasmal Pneumonia Cases and Cause of Misdiagnosis

CAO Shi-peng; YIN Ke; FU Man-jiao

doi:10.3969/j.issn.1002-3429.2015.10.012

Abstract：Objective To analyze the clinical features and misdiagnosis cause of adult mycoplasmal pneumonia ( AMP) patients in order to improve the diagnosis level of AMP. Methods The clinical data of 55 AMP admitted to Chang-sha central hospital during Jan 2012 and June 2014 were collected and retrospectively analyzed. Results The main clinical symptoms of AMP were cough, expectoration and fever, which were combined with a variety of extrapulmonary manifestations:sore throat (45. 5%), joint and, muscle pain (36. 4%), headache (27. 3%), diarrhea (14. 5%), rash (7. 3%), earache (3. 6%). White blood cell counts and neutrophil percentage were mostly normal (76. 4%), a small number of cases (9. 1%) can produce common pathogenic bacteria. Imaging manifestations were mainly ground glass opacity (65. 5%) and patchy shadows (23. 6%). Lesions often occurred in the upper lung (69. 1%) or simultaneously occurred in the bilateral lung (65. 5%). Mycoplasma pneumoniae antibody titers were often positive in the second week (54. 5%) and third week (36. 4%) of the course, the serum mycoplasma pneumoniae antibody titers in intervals of 7 to 14 days were 4 times or more than 4 times higher in 45 cases(81. 8%). the clinical misdiagnosis rate of AMP was high (74. 5%,41/45). The misdiag-nosed diseases were:15 cases of infiltrative pulmonary tuberculosis (36. 6%), 14 cases of viral pneumonia (34. 1%), 5 ca-ses of acute bronchitis (12. 2%), 2 cases of simple Streptococcus pneumoniae pneumonia (4. 9%), 5 cases of missed diag-nosis (12. 2%);macrolide antibiotics were preferred for treatment of 55 AMP patients, treatment effect of 6 cases (10. 9%) was invalid, but were cured after they used respiratory fluoroquinolone antibiotics. Conclusion Clinician should pay more at-tention to diagnosis of AMP. Routine detection of mycoplasma pneumoniae antibody is essential and dynamic observation is needed and diagnosis of the disease should not be excluded because of a single negative antibody detection.