Pediatric investigation · 2019
Clinicoradiologic features of Mycoplasma pneumoniae bronchiolitis in children.
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Wen Xiaohui, Liu Jinrong, Li Huimin, Zhao Chengsong, Zhao Shunying
Аннотация
IMPORTANCE: Acute Mycoplasma pneumoniae bronchiolitis can progress into bronchiolitis obliterans (BO) in children, which has a major influence on a child's quality of life and is associated with M. pneumoniae bronchiolitis. Early identification and treatment of M. pneumoniae bronchiolitis is important to prevent the development of BO.
OBJECTIVE: To enhance the understanding of the diagnosis and treatment of M. pneumoniae bronchiolitis in children.
METHODS: Eight patients with M. pneumoniae bronchiolitis were retrospectively analyzed.
RESULTS: Five of the patients with M. pneumoniae bronchiolitis were male and three of them were female. All patients suffered from fever and cough. Moist rales and wheezing were noted in both lungs in six patients. High-resolution computed tomography of the chest showed bronchiolitis in all patients, with large airway injury in two and focal bronchopneumonia in six. Two patients were confirmed to have asthma. Seven patients had personal and/or family histories of atopic diseases. Allergen testing was performed in six patients, which produced positive results in four; the remaining two patients had negative results, but their total IgE levels were > 200 IU/ml. Azithromycin therapy and glucocorticoid therapy was administered to all eight patients. One patient required noninvasive ventilation. Treatment of all patients was successful, with no development of bronchiolitis obliterans during the 4- to 8-month follow-up.
INTERPRETATION: Mycoplasma pneumoniae bronchiolitis can occur in children, especially in atopic individuals. The use, time of initiation, and effects of glucocorticoids administration in these patients for the prevention of BO require further investigation.
OBJECTIVE: To enhance the understanding of the diagnosis and treatment of M. pneumoniae bronchiolitis in children.
METHODS: Eight patients with M. pneumoniae bronchiolitis were retrospectively analyzed.
RESULTS: Five of the patients with M. pneumoniae bronchiolitis were male and three of them were female. All patients suffered from fever and cough. Moist rales and wheezing were noted in both lungs in six patients. High-resolution computed tomography of the chest showed bronchiolitis in all patients, with large airway injury in two and focal bronchopneumonia in six. Two patients were confirmed to have asthma. Seven patients had personal and/or family histories of atopic diseases. Allergen testing was performed in six patients, which produced positive results in four; the remaining two patients had negative results, but their total IgE levels were > 200 IU/ml. Azithromycin therapy and glucocorticoid therapy was administered to all eight patients. One patient required noninvasive ventilation. Treatment of all patients was successful, with no development of bronchiolitis obliterans during the 4- to 8-month follow-up.
INTERPRETATION: Mycoplasma pneumoniae bronchiolitis can occur in children, especially in atopic individuals. The use, time of initiation, and effects of glucocorticoids administration in these patients for the prevention of BO require further investigation.