Analysis on clinical characteristics of severe and critical Mycoplasma pneumoniae pneumonia in children of different ages

REN Xue; WANG Lijie

doi:10.3969/j.issn.1674-3806.2025.08.04

Abstract：Objective To analyze the clinical characteristics of severe and critical Mycoplasma pneumoniae pneumonia in children of different ages,and to provide theoretical basis for early clinical identification and standardized treatment of the disease.Methods The clinical data of 83 pediatric patients with severe and critical Mycoplasma pneumoniae pneumonia who were admitted to the Pediatric Intensive Care Unit of Shengjing Hospital of China Medical University from October 2023 to June 2024 were retrospectively analyzed.These pediatric patients were divided into infants and young children group(＜3 years,23 patients),preschool children group(3-6 years,17 patients)and school-age children group(＞6 years,43 patients)according to their different ages,and their clinical data were analyzed.Results All the pediatric patients had cough,and most of them presented with cough as the initial manifestation,and 79 pediatric patients(95.18％)were accompanied by fever.In the 83 pediatric patients,22 pediatric patients(26.51％)experienced wheezing during the course of the disease.Wheezing was more common in the infants and young children group.Among the 29 pediatric patients(34.94％)who experienced dyspnea,the majority were from the school-age children group.The neutrophil to lymphocyte ratio and C-reactive protein in the blood of the pediatric patients were significantly higher than the normal values,while their procalcitonin and interleukin-6 did not increase significantly.The chest imaging manifestations of the pediatric patients were mostly characterized by diffuse consolidation shadows,followed by bronchiolitis manifestations.The chest imaging patterns varied among different age groups of the pediatric patients.Some of the pediatric patients had extrapulmonary complications.In the 83 pediatric patients,21 pediatric patients(25.30％)were accompanied by mixed infections of other viruses.The course of the disease in the pediatric patients with mixed infections was longer than that in the pediatric patients with single Mycoplasma pneumoniae infection.With effective control of pathogens,the progression of the disease could be halted in the most pediatric patients within a short period of time after the administration of conventional doses of glucocorticoids.After effective treatments,all the pediatric patients improved and were discharged from the hospital.The follow-up results showed that only a few pediatric patients had sequelae.Conclusion Severe Mycoplasma pneumoniae pneumonia and critical Mycoplasma pneumoniae pneumonia have the same clinical characteristics in pediatric patients of different ages,but also have unique clinical manifestations in pediatric patients of various age groups.Early identification of the disease and taking targeted intervention measures can lead to a better prognosis for the pediatric patients.