Early prediction of necrotizing pneumonia from mycoplasma pneumoniae pneumonia with large pulmonary lesions in children

Abstract

To compare the different features of necrotizing pneumonia (NP) and non-NP (NNP) caused by Mycoplasma pneumoniae pneumonia (MPP) with large pulmonary lesions, and explore the predictor for NP to differentiate from MPP. A retrospective study of MPP patients with large pulmonary lesions hospitalized from January 2008 to December 2019 was enrolled, and clinical manifestations, laboratory findings, radiological findings were analyzed. Of 135 MPP patients with large pulmonary lesions, 56 were in the NP group, 79 were in the NNP group. We found the median length of fever days were much longer in NP group than those in NNP group. Higher levels of WBC, CRP, LDH, IL-6 in NP group were observed. Furthermore, the incidence of pulmonary consolidation was much higher in NP patients than that in NNP patients, while the CT value of large pulmonary lesion was much lower in NP patients. In ROC curve analysis, the cut-off values for the CT value and IFN-γ were 36.43 and 7.25 pg/ml, respectively. NP caused by MPP might be easier to suffer from prolonged clinical course, severe laboratory and radiological findings. CT value of large pulmonary lesions and IFN-γ could be used as biomarkers to predict NP from MPP with large pulmonary lesions in children.

Diagnosis and Prognostic Analysis of Mycoplasma pneumoniae Pneumonia in Children Based on High‐Resolution Computed Tomography

“…Date for MPP in China is scarce. Data show that MP infection accounts for 10–40% of community-acquired pneumonia (CAP) in children at 9–14 years old, with a peak age of 4–6 years [ 2 ]. The clinical manifestations and chest X-ray examination of MPP are not characteristic, and the diagnosis cannot be made based on the clinical manifestations and chest X-ray examination alone.…”

Early predictors of lung necrosis severity in children with community-acquired necrotizing pneumonia

“…Our data also demonstrated that M. pneumonia was the primary etiology in the mild and moderate necrosis groups, which highlighted its importance in pediatric NP. The incidence of M. pneumonia -associated NP appears to be increasing according to recent reports, particularly in China 20,21 . Previous studies have demonstrated significantly higher WBC, CRP, and LDH levels and lower serum albumin and sodium levels in the NP group than in the control groups 20,22 .…”

“…The incidence of M. pneumonia -associated NP appears to be increasing according to recent reports, particularly in China 20,21 . Previous studies have demonstrated significantly higher WBC, CRP, and LDH levels and lower serum albumin and sodium levels in the NP group than in the control groups 20,22 . Similarly, the univariate analysis showed that these indices were significantly correlated with lung necrosis severity.…”

Application of CT images based on the optimal atlas segmentation algorithm in the clinical diagnosis of Mycoplasma Pneumoniae Pneumonia in Children

“…Due to the immature development of alveoli in children, the lung capacity is small, and the traction of alveoli on the surrounding airways was insufficient, leading to increased lung texture. 12 , 13 This is consistent with the findings of Nakanishi et al 14 After the treatment, the CT images of the patients showed decreased lesion density, lesion range, and patchy shadow absorption, which suggested that antibiotics, arena corticosteroids, and other comprehensive treatments effectively killed Mycoplasma pneumoniae 15 , which was similar to the findings in a study by Matthys et al 16 HRCT examination of one child with mycoplasma pneumonia showed that the patient mainly had multiple patchy lesions in the anterior and posterior segments of the upper lobe tip of the left lung. It mainly presented small patchy high-density shadows with blurred edges, tree buds were seen, bronchial wall thickened and lung texture thickened and thickened, showing cable-like shadows.…”