Clinical Characteristics and Misdiagnosis of Adult Mycoplasmal Pneumonia with Extrapulmonary Manifestations

XIONG Xin; LIU Ling; ZHOU Rongrong; XUE Bing

doi:10.3969/j.issn.1002-3429.2024.10.002

Abstract：Objective To analyze the clinical characteristics and misdiagnosis of adult mycoplasmal pneumonia(AMP)with extrapulmonary manifestations.Methods The clinical data of 60 adult patients with AMP and positive DNA de-tection of mycoplasma pneumoniae from January 2022 to June 2023 were retrospectively analyzed,and were divided into pres-ence of extrapulmonary manifestation group(n=29)and absence of extrapulmonary manifestation group(n=31)according to presence or absence of extrapulmonary manifestations.Blood coagulation function,biochemical indexes,out-of-hospital course of disease,length of hospital stay,proportion of misdiagnosis and duration of misdiagnosis were compared between the two groups.Results Among the 60 patients with AMP,31 patients(51.67%)had extrapulmonary manifestations,and the com-mon extrapulmonary manifestations included fatigue in 18(30.00%)patients,joint muscle pain in 16(26.67%)patients,headache in7(11.67%)patients,poor appetite in7(11.67%)patients,diarrhea in7(11.67%)patients,drowsiness in 4(6.67%)patients,rash in 3(5.00%)patients,nausea in 2(3.33%)patients.lumbago in 1(1.67%)patient,and black stool in 1(1.67%)patient.The average levels of C-reactive protein,aspartate aminotransferase,lactate dehydrogen-ase,α-hydroxybutyrate dehydrogenase and fibrinogen in the presence of extrapulmonary manifestation group were higher than those in the absence of extrapulmonary manifestation group(P＜0.05).The length of hospital stay and duration of misdiagno-sis in the presence of extrapulmonary manifestation group were longer than those in the absence of extrapulmonary manifestation group(P＜0.05).There was no significant difference in the out-of-hospital course of disease between the two groups(P＞0.05).The proportion of misdiagnosis in the presence of extrapulmonary manifestation group was higher than that in the ab-sence of extrapulmonary manifestation group(P＜0.05).Conclusion MPP in adults has a high incidence of extrapulmonary manifestations.AMP with extrapulmonary manifestations has a higher degree of inflammation,a longer length of hospital stay,and a higher proportion of misdiagnosis.Clinical attention should be paid to the monitoring of biochemical indicators and coag-ulation function in this population,timely detection of disease changes,so as to avoid misdiagnosis and missed diagnosis and delayed treatment.