Analysis of clinical characteristics of severe mycoplasma pneumoniae pneumonia complicated with virus infection in children

Abstract

Background To summarize the pathogenesis and etiological characteristics of Severe Mycoplasma Pneumoniae Pneumonia (SMPP) with viral infection. Methods SMPP patients admitted to Affiliated Hospital of Jining Medical Universityfrom July 2021 to June 2022 requiring bronchoscopic alveolar lavage were retrospectively collected. Multiple reverse transcription polymerase chain reaction (mRT-PCR) was used to detect respiratory pathogens combined with serum mycoplasma antibody titer. The children were divided into Mycoplasma Pneumoniae (MP) infection group and MP mixed virus infection group according to whether they were infected with mixed virus or not. The differences of clinical manifestations, physical examination, laboratory examination, imaging data and bronchoscopy manifestations were analyzed. Results Among 784 children with SMPP, 425 were males (54.21%) and 359 were females (45.79%). The ratio of males to females was 1.18:1. Children over 5 years old were the high incidence group of SMPP. There were 638 cases of single MP infection (81.38%), 146 cases of co-infection (18.62%), and the top two cases of co-infection were adenovirus (ADV) in 74 cases (50.68%) and respiratory syncytial virus (RSV) in 67 cases (45.89%). Compared with the MP mixed virus infection group, there were statistically significant differences in age, season, hospital stay, fever time, lung consolidation and emphysema (P < 0.05), but no significant differences in other clinical manifestations, laboratory indicators and bronchoscopy (P > 0.05). Compared with MP mixed ADV group, there were significant differences in the level of lactate dehydrogenase and season (P < 0.05). Conclusion Adenovirus and respiratory syncytial virus are the most common co-infected viruses of SMPP. In terms of laboratory indexes and fiberoptic bronchoscopy, the disease characteristics of single MP infection group, mixed virus infection group, MP mixed ADV group and MP mixed RSV group were similar. The age of MP patients with virus infection was younger, the hospitalization time was longer, the fever time was longer, and the patients with emphysema were more. The level of lactate dehydrogenase in children with RSV infection was higher than that in patients with ADV infection.