Pulmonary and Extrapulmonary Manifestations in Hospitalized Children with Mycoplasma Pneumoniae Infection.
Pulmonary and Extrapulmonary Manifestations in Hospitalized Children with Mycoplasma Pneumoniae Infection.
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DOI：
10.3390/microorganisms9122553
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发表时间：
2021-12-10
期刊：
影响因子：
4.5
通讯作者：
Lanari M
中科院分区：
文献类型：
--
作者：
Biagi C;Cavallo A;Rocca A;Pierantoni L;Antonazzo D;Dondi A;Gabrielli L;Lazzarotto T;Lanari M
肺炎支原体(MP)是学龄儿童上呼吸道和下呼吸道感染的主要原因之一，占社区获得性肺炎的40%。年龄较小的儿童也会受到影响，最近在儿科人群中报告了肺外表现。我们对2012至2020年间入住博洛尼亚S.Orsola Malpighi大学医院儿科急诊科的MP阳性患者进行了回顾性分析，S.Orsola Malpighi医院是意大利北部埃米利亚-罗马尼亚地区最大的三级儿科转诊中心。我们确定了145名MP感染患者(82名男性和63名女性)，其中27%的人年龄在2岁以下；中位数年龄为5岁(四分位数范围1-9)。临床表现在不同年龄组之间部分不同。学龄儿童更有可能患有胸部X光确诊的肺炎(p=0.013)，而年龄较小的儿童更经常需要氧气治疗(p=0.048)。74名儿童(51%)有肺外表现，主要是胃肠道(30%)和皮肤病(14%)。神经症状在6岁以上的儿童中更常见(p=0.006)。其他肺外表现的发生率在不同年龄组之间没有显著差异。这项研究表明，肺炎支原体感染是儿科住院的常见原因，包括2岁以下儿童。临床医生应该意识到MP的不同临床表现，包括肺外表现，以实现正确的诊断和决定适当的治疗。
Mycoplasma pneumoniae (MP) is one of the main causes of both upper and lower respiratory infections in school-aged children, accounting for up to 40% of community-acquired pneumonia. Younger children are also affected, and extrapulmonary manifestations have been recently reported in the pediatric population. We carried out a retrospective analysis of MP-positive patients admitted to the Pediatric Emergency Unit of S. Orsola Malpighi University Hospital in Bologna, the largest tertiary pediatric referral center in the Emilia–Romagna region, Northern Italy, between 2012 and 2020. We identified 145 patients with MP infection (82 males and 63 females), 27% of which were younger than 2 years; the median age was 5 years (interquartile range 1–9). The clinical presentation partially differed between age groups. School-aged children were more likely to have a chest X-ray-confirmed pneumonia (p = 0.013), while younger children required oxygen therapy more often (p = 0.048). Seventy-four children (51%) showed extrapulmonary manifestations, mainly gastrointestinal (30%) and dermatological (14%). Neurological symptoms were more frequent in children older than 6 years (p = 0.006). The rate of other extrapulmonary manifestations did not differ significantly between age groups. This study shows that MP infection is a frequent cause of pediatric hospitalization, including of children younger than 2 years. Clinicians should be aware of the variable clinical expressions of MP, including extrapulmonary manifestations, to achieve a correct diagnosis and determine appropriate treatment.
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