A decade of pediatric Mycoplasma pneumoniae infections: clinical features, extrapulmonary findings, and predictors associated with advanced care markers abstract

Abstract

Aims: This study aimed to to describe clinical and radiological characteristics of cold agglutinin-positive pediatric patients and to evaluate factors associated markers of disease severity, including CT utilization, respiratory support and length of hospitalization, in patients with suspected Mycoplasma pneumonia infection and cold agglutination positivity. Methods: A retrospective analysis was conducted on patients aged 0-18 years who presented to the pediatric clinics of Necmettin Erbakan University between January 2015 and January 2025 and had cold agglutinin positivity. Demographics, presenting symptoms, pulmonary and extrapulmonary findings, imaging results, treatment settings, respiratory support needs, and laboratory parameters were extracted from medical records. Comparative analyses between patients with and without chest CT imaging were performed using appropriate statistical tests. Results: A total of 242 patients (52.9% female; mean age 8.31±4.41 years) were included. The most frequent symptoms were cough (83.5%), nonspecific complaints (42.6%), and fever (38.4%). Abnormal respiratory findings were present in 45.0%, most commonly bilateral crackles. Extrapulmonary manifestations occurred in 20.2% of patients. Chest X-rays showed bilateral involvement in 47.9%. Patients who underwent CT imaging had significantly higher rates of abnormal respiratory findings, increased need for supplemental oxygen or noninvasive support, and longer hospital stays (p<0.001). Conclusion: Cold agglutination–positive pediatric patients demonstrated a wide clinical spectrum. The association between CT utilization and markers of more severe disease underscores the need for careful monitoring and early recognition of high-risk cases.

Keywords

• Child
• cold agglutination
• Mycoplasma
• pneumonia

Çocuklarda görülen mikoplazma pnömonisi enfeksiyonlarının on yılı: klinik özellikler, akciğer dışı bulgular ve ileri bakım gereksinimlerini belirleyen faktörler

Abstract

Amaç: Bu çalışma, soğuk aglütinasyon testi pozitifliği olan pediatrik hastalarda klinik, radyolojik ve laboratuvar özelliklerini tanımlamayı ve Mycoplasma pneumoniae enfeksiyonlarında şiddetle ilişkili faktörleri belirlemeyi amaçlamıştır. Yöntemler: Ocak 2015 ile Ocak 2025 tarihleri ​​arasında Necmettin Erbakan Üniversitesi pediatri kliniklerine başvuran ve soğuk aglütinasyon testi pozitif olan 0-18 yaş arası hastalar üzerinde retrospektif bir analiz yapılmıştır. Demografik bilgiler, başvuru semptomları, akciğer ve akciğer dışı bulgular, görüntüleme sonuçları, tedavi ayarları, solunum desteği ihtiyaçları ve laboratuvar parametreleri tıbbi kayıtlardan çıkarılmıştır. Göğüs BT görüntülemesi olan ve olmayan hastalar arasında uygun istatistiksel testler kullanılarak karşılaştırmalı analizler yapılmıştır. Sonuçlar: Toplam 242 hasta (kadın oranı %52,9; ortalama yaş 8,31±4,41 yıl) çalışmaya dahil edilmiştir. En sık görülen semptomlar öksürük (%83,5), spesifik olmayan şikayetler (%42,6) ve ateş (%38,4) olmuştur. Anormal solunum bulguları %45,0 oranında mevcuttu ve en sık olarak bilateral çıtırtılar görüldü. Akciğer dışı belirtiler hastaların %20,2'sinde ortaya çıktı. Göğüs röntgenlerinde %47,9 oranında bilateral tutulum görüldü. BT görüntülemesi yapılan hastalarda anormal solunum bulguları, ek oksijen veya noninvaziv ventilasyon ihtiyacı ve daha uzun hastane yatış süreleri anlamlı derecede daha yüksekti (p<0,001). Sonuç: Soğuk aglütinasyon pozitif pediatrik hastalar geniş bir klinik spektrum sergiledi. BT kullanımının daha şiddetli hastalık belirteçleriyle ilişkisi, yüksek riskli vakaların dikkatli bir şekilde izlenmesi ve erken teşhisinin gerekliliğini vurgulamaktadır.

Keywords

• çocuk
• soğuk agglütinasyon
• Mycoplasma
• pnömoni

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