Abstract
Objectives:
Mycoplasma pneumoniae
(MP) pneumonia in children has varied pulmonary and extra-pulmonary manifestations. Atypical presentations and emerging macrolide resistance pose a great challenge. To determine proportional morbidity among the children admitted with pneumonia and study clinical, laboratory, radiological findings, management of MP pneumonia (MPP), among hospitalized community-acquired pneumonia (CAP) cases in a tertiary care setting.
Material and Methods:
Retrospective observational study. Inpatient case records 1 month–18 years with MPP (polymerase chain reaction [PCR] and/or immunoglobulin M positive) between January 2023 and December 2024 at an urban tertiary care center. The outcomes studied include age, symptom distribution, investigations, treatment response, extra-pulmonary manifestations, proportional morbidity.
Results:
Thirty-two had MPP. 24 (75%) were above 5 years, and boys 25 (78%). Fever 32 (100%) and cough 29 (90.6%) most common. PCR positive 25 (78%). Chest X-ray: Consolidation-16 (50%) and pleural effusion-7 (21.9%). Four (12.5%) each showed leukocytosis and transaminitis. Abnormal C-reactive protein (CRP) in 25 (78.12%). Macrolide treatment in 30 (93.7%). 6 (18.8%) required pediatric intensive care unit. Skin rash, arrhythmia, and transaminitis in 7 (21.9%). Isolated MP infection 18 (56.25%).
Discussion:
1514 had CAP. 32 (2.11%) had MPP. Majority above 5 years and were boys. Fever and cough predominant symptoms. Chest X-ray: Consolidation-16 (50%) and pleural effusion-7 (21.9%). Extra-pulmonary manifestation correlated with high CRP. Most improved by 5 days with macrolides.
Conclusion:
MPP predominantly affects older children above 5 years. Fever and cough are the most common. PCR is the most sensitive diagnostic tool. Macrolide therapy is effective. Extra-pulmonary manifestations if high CRP.