Correlation Between the Clinical Severity, Bacterial Load, and Inflammatory Reaction in Children with Mycoplasma Pneumon
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Correlation Between the Clinical Severity, Bacterial Load, and Inflammatory Reaction in Children with Mycoplasma Pneumoniae Pneumonia* Chen ZHANG†, Qiao ZHANG†, Jie-lin DU, Dan DENG, Ye-lei GAO, Cheng-lin WANG, Hong-jie ZHAO, Qian GUO, Zhou FU, Dai-yin TIAN# Department of Pulmonology, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China Huazhong University of Science and Technology 2020
Summary: Given the lack of defining features in the clinical manifestations and radiographic findings for children with mycoplasma pneumoniae pneumonia (MPP), quantitative polymerase chain reaction (qPCR) has become a useful diagnostic method. This study was performed to explore the relationship between the qPCR findings, clinical symptoms, and inflammatory markers in children with MPP. Four hundred children with MPP have been enrolled in this retrospective analysis. All clinical and analytical information, including mycoplasma pneumoniae (MP) PCR results, has been collected. Based on the PCR results, the patients were divided into groups with load values (copy number) < 105 (54 cases), ≥105 and duration of fever > period of hospitalization > LDH value > C-reactive protein value. The host immune response was significantly greater in the complication group than in the non-complication group. Key words: mycoplasma pneumonia; quantitative polymerase chain reaction; bacterial load
Mycoplasma pneumoniae (MP) is a common cause of community-acquired pneumonia and upper respiratory tract infections, particularly in children and adolescents, and accounts for approximately 10%– 30% of all community-acquired pneumonia[1]. MP pneumonia (MPP) is considered a self-limited disease; however, it may cause various pulmonary symptoms, such as fever, dry cough, dyspnea, wheezing, etc. Extrapulmonary complications induced by MPP can lead to severe life-threatening disorders[2–4]. The onset of MPP is usually sudden and unpredictable with non-specific symptoms, such as headache, malaise, and emesis[5]. Chen ZHANG, E-mail: [email protected]; Qiao ZHANG, E-mail: [email protected] † The authors contributed equally to this study. # Corresponding author, E-mail: [email protected]. cn * This study was supported by the Chongqing Science and Health Joint Medical Research Project (No. 8187011078)
The radiological features of the extra-pulmonary complications of MPP are often highly variable in patients. Pleural effusion has been shown to occur in 20% of patients with MPP by standard, posterioranterior, and lateral chest radiographs[6]. In the early stages, MPP can be easily misdiagnosed clinically due to lack of symptoms, specific clinical features, and consistency in radiological manifestations[3, 7]. Since MP does not have a cellular wall, it is not sensitive to most antibiotics. However, erythromycin, clarithromycin, azithromycin, and tetracyclines exhibit effective in vitro bac
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