Presence of consolidation or atelectasis in children with Mycoplasma pneumoniae pneumonia is associated with poor prognosis, suggests a study published in the December 2023 issue of the journal Respiratory Medicine.¹

From January 2019 to December 2021, a total of 1401 patients, aged ≥28 days and <18 years, who had been hospitalized with Mycoplasma pneumoniae pneumonia at the Children’s Hospital of Nanjing Medical University in Nanjing, China were recruited for this prospective study. All participants underwent chest x-ray and 660 underwent chest CT scan. Findings on x-ray were classified as bronchopneumonia and consolidation/atelectasis and findings on CT were collated as bronchopneumonia, atelectasis, bronchiolitis and mosaic pattern. The electronic medical records of the patients were utilized to examine the clinical features and outcomes of patients with various imaging classifications. The study participants were followed up till June 1, 2022.

The most frequently diagnosed condition on chest x-ray was bronchopneumonia(59.6%). On chest CT scan, the most common finding was consolidation/atelectasis (70.9%), followed by bronchopneumonia (14.4%), bronchiolitis (11.5%), and mosaic pattern (3.2%).

Consolidation/atelectasis represented the most severe category of illness with serious abnormalities as shown by laboratory indicators and clinical presentations. They also had higher CRP, NLR and LDH levels vs other groups. The outcomes were worse in these patients; they required prolonged hospitalization, longer total duration of fever and were at a higher risk of developing refractory MPP, necrotizing pneumonia, and bronchiolitis obliterans. School-age and preschoolers had higher prevalence of consolidation/atelectasis compared to infants.

Mycoplasma pneumoniae is one of the most common etiopathogens of community acquired pneumonia in children. Although self-limiting, complications may occur heralding a poor prognosis. Hence, early diagnosis and management is important. This study attempted to find out if the clinical features and outcomes of Mycoplasma pneumoniae pneumonia were related to the classification of imaging findings. Based on the findings, the study concluded that developing an imaging-based classification system is very valuable from a clinical standpoint, as different imaging classifications have different clinical features and outcomes.

Reference

1.     Xia Huang, et al. Chest imaging classification in Mycoplasma pneumoniae pneumonia is associated with its clinical features and outcomes. Respir Med. 2023 Dec 1:107480. doi:10.1016/j.rmed.2023.107480.