Clinical Misdiagnosis of Mycoplasma Pneumoniae Pneumonia in Children

SHI Linyan; MA Kexing

doi:10.3969/j.issn.1002-3429.2024.20.004

Abstract：Objective To investigate the causes of clinical misdiagnosis of mycoplasma pneumoniae pneumonia(MPP)in children.Methods The data of 2 children with MPP who were initially misdiagnosed in our hospital from March 2019 to September 2022 were retrospectively analyzed.Results A child with fever accompanied by cough had a thick respira-tory sound in both lungs,and chest CT scan showed multiple irregular spots in the subpleura of the right lung.He was initially diagnosed as novel coronavirus pneumonia(NCP)due to his treatment during the epidemic period of novel coronavirus infec-tion,but no improvement was observed after targeted treatment.The results of throat swab,sputum and novel coronavirus nu-cleic acid test were negative,and MPP was confirmed after testing positive for mycoplasma pneumoniae antibodies.A child was admitted to the hospital with bronchopneumonia due to cough and sputum for 7 d and acute aggravation for 3 d,and the anterolateral chest X-ray showed patchy high-density shadows in the middle and lower field of the right lung,and the patient was admitted to the hospital with bronchopneumonia.No improvement was achieved after targeted treatment.After bronchoal-veolar lavage fluid DNA-pathogenic microorganisms were tested positive for mycoplasma pneumoniae,MPP was confirmed.The misdiagnosis lasted 5-6 d.After diagnosis,Azithromycin was given anti-infection and antipyretic treatment,as well as cough and phlegm relief.Conclusion MPP in children often lacks specific clinical symptoms and is prone to misdiagnosis in clinical treatment.For children with persistent fever and severe cough but not obvious pulmonary signs,receiving doctors should consider the possibility of MPP,pay special attention to this disease,and perform differential diagnosis carefully,to avoid misdiagnosis and mistreatment.