Clinical manifestations in infants and children with Mycoplasma pneumoniae infection

Mia Johanna Søndergaard, Martin Barfred Friis, Dennis Schrøder Hansen, Inger Merete Jørgensen, Mia Johanna Søndergaard, Martin Barfred Friis, Dennis Schrøder Hansen, Inger Merete Jørgensen

Abstract

Background: Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in older children. Pulmonary and extra-pulmonary symptoms associated with M. pneumoniae infection are reported. M. pneumoniae is mainly epidemic in Denmark with the recurrence every 4-7th year.

Aims: Retrospectively, to describe the epidemiology and clinical features, in infants and children, during the M. pneumoniae epidemic in 2010 and 2011.

Methods: All children under the age of 16 that were tested for M. pneumoniae during the period 01.02.2010-31.01.2012 were included. Medical charts, as well as radiological findings, were reviewed for all children with M. pneumoniae. A post-hoc analysis of viral co-infections was done on part of the cohort.

Results: 134 of 746 children were tested positive for M. pneumoniae by PCR or serology. Positive tests were found in 65% of children seven years and older, in 30% of 2-6-year-olds and 4% of infants (less than two years of age). Viral co-infection was found in 27% of the tested samples. The clinical presentation was a cough, asthma-like symptoms and low-grade fever. Extra-pulmonary symptoms were common and presented as nausea/vomiting by 33% of the children and skin manifestations by 25%. 84% of the children had a chest x-ray taken, and there were positive radiological findings in 94% of these.

Conclusion: M. pneumoniae also affected infants and young children and symptoms were similar to infections with respiratory viruses, but severe LRTI were also seen. During an up-coming epidemic, assessment of extra-pulmonary manifestations can be helpful when diagnosing M. pneumoniae infections.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Number of positive and negative…
Fig 1. Number of positive and negative M. pneumoniae tests by year and month.

References

    1. Waites KB. New concepts of Mycoplasma pneumoniae infections in children. Pediatr Pulmonol. 2003;36: 267–278. doi:
    1. Hornsleth A. [The virology of acute respiratory tract infections. 1. A survey on the etiology in children]. Ugeskr Laeger. 1967;129: 1253–1258.
    1. Hornsleth A. [The virology of acute respiratory tract infections. 2. Isolation of viruses in hospitalized children]. Ugeskr Laeger. 1967;129: 1259–1265.
    1. Harris M, Clark J, Coote N, Fletcher P, Harnden A, McKean M, et al. British Thoracic Society guidelines for the management of community-acquired pneumonia in children: update 2011. Thorax. 2011;66 Suppl 2: ii1–23. doi:
    1. Zalenzink D, Vallejo J. Mycoplasma pneumonia infection in children. 2009th ed. UpToDate.
    1. Glezen WP, Loda FA, Clyde WA, Senior RJ, Sheaffer CI, Conley WG, et al. Epidemiologic patterns of acute lower respiratory disease of children in a pediatric group practice. J Pediatr. 1971;78: 397–406. doi:
    1. Uldum SA, Bangsborg JM, Gahrn-Hansen B, Ljung R, Mølvadgaard M, Føns Petersen R, et al. Epidemic of Mycoplasma pneumoniae infection in Denmark, 2010 and 2011. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2012;17.
    1. Sørensen CM, Schønning K, Rosenfeldt V. Clinical characteristics of children with Mycoplasma pneumoniae infection hospitalized during the Danish 2010–2012 epidemic. Dan Med J. 2013;60: A4632
    1. Defilippi A, Silvestri M, Tacchella A, Giacchino R, Melioli G, Di Marco E, et al. Epidemiology and clinical features of Mycoplasma pneumoniae infection in children. Respir Med. 2008;102: 1762–1768. doi:
    1. Gadsby NJ, Reynolds AJ, McMenamin J, Gunson RN, McDonagh S, Molyneaux PJ, et al. Increased reports of Mycoplasma pneumoniae from laboratories in Scotland in 2010 and 2011—impact of the epidemic in infants. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2012;17.
    1. Othman N, Isaacs D, Kesson A. Mycoplasma pneumoniae infections in Australian children. J Paediatr Child Health. 2005;41: 671–676. doi:
    1. Chalker V, Stocki T, Litt D, Bermingham A, Watson J, Fleming D, et al. Increased detection of Mycoplasma pneumoniae infection in children in England and Wales, October 2011 to January 2012. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2012;17.
    1. Almasri M, Diza E, Papa A, Eboriadou M, Souliou E. Mycoplasma pneumoniae respiratory tract infections among Greek children. Hippokratia. 2011;15: 147–152.
    1. Inchley CS, Berg AS, Vahdani Benam A, Kvissel AK, Leegaard TM, Nakstad B. Mycoplasma Pneumoniae: A Cross-sectional Population-based Comparison of Disease Severity in Preschool and School-age Children. Pediatr Infect Dis J. 2017;36: 930–936. doi:
    1. Spuesens EBM, Fraaij PLA, Visser EG, Hoogenboezem T, Hop WCJ, van Adrichem LNA, et al. Carriage of Mycoplasma pneumoniae in the upper respiratory tract of symptomatic and asymptomatic children: an observational study. PLoS Med. 2013;10: e1001444 doi:
    1. Fleming S, Thompson M, Stevens R, Heneghan C, Plüddemann A, Maconochie I, et al. Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a systematic review of observational studies. The Lancet. 2011;377: 1011–1018. doi:
    1. Gardiner SJ, Gavranich JB, Chang AB. Antibiotics for community-acquired lower respiratory tract infections secondary to Mycoplasma pneumoniae in children In: The Cochrane Collaboration, editor. Cochrane Database of Systematic Reviews. Chichester, UK: John Wiley & Sons, Ltd; 2015. doi:
    1. Korppi M, Heiskanen-Kosma T, Kleemola M. Incidence of community-acquired pneumonia in children caused by Mycoplasma pneumoniae: serological results of a prospective, population-based study in primary health care. Respirol Carlton Vic. 2004;9: 109–114. doi:
    1. Stokholm J, Chawes BL, Vissing NH, Bjarnadóttir E, Pedersen TM, Vinding RK, et al. Azithromycin for episodes with asthma-like symptoms in young children aged 1–3 years: a randomised, double-blind, placebo-controlled trial. Lancet Respir Med. 2016;4: 19–26. doi:
    1. Stokholm J, Bisgaard H. Chronic Chlamydia pneumoniae lung infection: a neglected explanation for macrolide effects in wheezing and asthma?–Authors’ reply. Lancet Respir Med. 2016;4: e8–e9. doi:
    1. Berg AS, Inchley CS, Aase A, Fjaerli HO, Bull R, Aaberge I, et al. Etiology of Pneumonia in a Pediatric Population with High Pneumococcal Vaccine Coverage: A Prospective Study. Pediatr Infect Dis J. 2016;35: e69–75. doi:
    1. Mulholland S, Gavranich JB, Gillies MB, Chang AB. Antibiotics for community-acquired lower respiratory tract infections secondary to Mycoplasma pneumoniae in children. Cochrane Database Syst Rev. 2012;9: CD004875 doi:
    1. Spuesens EBM, Meyer Sauteur PM, Vink C, van Rossum AMC. Mycoplasma pneumoniae infections—does treatment help? J Infect. 2014;69 Suppl 1: S42–46. doi:
    1. Statens Serum Institut. Mycoplasma pneumoniae infektioner. In: [Internet]. 27 Dec 2015. Available:
    1. Uldum SA, Amberg P, Jensen JS. [Macrolide resistance in Mycoplasma pneumoniae by recurrence and extended illness]. Ugeskr Laeger. 2012;174: 730–731.
    1. Bjørn A-MB, Lebech A-MK. [Extrapulmonary complications of Mycoplasma pneumoniae infections]. Ugeskr Laeger. 2002;164: 1805–1809.
    1. Tsai V, Oman J. Stevens-Johnson syndrome after mycoplasma pneumoniae infection. J Emerg Med. 2011;40: 324–327. doi:
    1. Olson D, Watkins LKF, Demirjian A, Lin X, Robinson CC, Pretty K, et al. Outbreak of Mycoplasma pneumoniae-Associated Stevens-Johnson Syndrome. Pediatrics. 2015;136: e386–394. doi:

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel