The Clinical Presentation of Pediatric Mycoplasma pneumoniae Infections—A Single Center Cohort. Issue 7 (July 2019)

• Record Type: Journal Article
• Authors: Gordon, Oren; Oster, Yonatan; Michael-Gayego, Ayelet; Marans, Rachel S.; Averbuch, Dina; Engelhard, Dan; Moses, Allon E.; Nir-Paz, Ran
• Is Part Of: Pediatric infectious disease journal. Volume 38:Issue 7(2019)
• Publication Date: 2019-07
• Subjects: Mycoplasma pneumoniae -- pneumonia -- children -- extrapulmonary manifestations; Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000002291
• Languages: English
• ISSNs: 0891-3668

Abstract

Abstract : Background: Mycoplasma pneumoniae (MP) is a major cause of community-acquired upper and lower respiratory infections in school-age children; however, there is increasing recognition that younger children are also affected. Clinical manifestations vary from asymptomatic, to severe complicated pneumonia sometimes with extrapulmonary manifestations. Methods: We reviewed the medical records of all MP positive pediatric patients admitted to the Hadassah-Hebrew University Medical Center. MP positive case was defined if MP polymerase chain reaction was positive from an oropharyngeal swab sent from 2007 to 2017. Results: During the study period, we identified 353 MP positive pediatric cases, of which 51.3% (181 of 353) were younger than 6 years old. Full clinical data were available for 332 of 353 (94%). The median age was 5.7 years (range, 3 weeks to 18 years). Disease presentation differed between younger and older children. Children older than 6 years were more likely to have chest radiograph confirmed pneumonia (66% vs. 52%; P = 0.009), while younger children were more likely to have other respiratory manifestations (37% vs. 25%; P = 0.017). The duration of hospitalization and pediatric intensive care unit admission rate, however, did not differ between age groups. The rate of extrapulmonary manifestations were also similar. Conclusions: MP-associated infection is a significant cause of hospitalization in the pediatric population including younger children (<6 years old). However, the clinical presentation in younger age is less typical than is thought. These findings should prompt clinicians to consider MP infections also in children younger than 6 admitted with fever even without pneumonia.