Biagi Carlotta, Cavallo Alessandra, Rocca Alessandro, Pierantoni Luca, Antonazzo Davide, Dondi Arianna, Gabrielli Liliana, Lazzarotto Tiziana, Lanari Marcello
Pediatric Emergency Unit, Scientific Institute for Research and Healthcare (IRCCS), Sant'Orsola Hospital, 40138 Bologna, Italy.
Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy.
Microorganisms. 2021 Dec 10;9(12):2553. doi: 10.3390/microorganisms9122553.
Mycoplasma pneumoniae (MP) is one of the main causes of both upper and lower respiratory infections in school-aged children, accounting for up to 40% of community-acquired pneumonia. Younger children are also affected, and extrapulmonary manifestations have been recently reported in the pediatric population. We carried out a retrospective analysis of MP-positive patients admitted to the Pediatric Emergency Unit of S. Orsola Malpighi University Hospital in Bologna, the largest tertiary pediatric referral center in the Emilia-Romagna region, Northern Italy, between 2012 and 2020. We identified 145 patients with MP infection (82 males and 63 females), 27% of which were younger than 2 years; the median age was 5 years (interquartile range 1-9). The clinical presentation partially differed between age groups. School-aged children were more likely to have a chest X-ray-confirmed pneumonia ( = 0.013), while younger children required oxygen therapy more often ( = 0.048). Seventy-four children (51%) showed extrapulmonary manifestations, mainly gastrointestinal (30%) and dermatological (14%). Neurological symptoms were more frequent in children older than 6 years ( = 0.006). The rate of other extrapulmonary manifestations did not differ significantly between age groups. This study shows that MP infection is a frequent cause of pediatric hospitalization, including of children younger than 2 years. Clinicians should be aware of the variable clinical expressions of MP, including extrapulmonary manifestations, to achieve a correct diagnosis and determine appropriate treatment.
肺炎支原体（MP）是学龄儿童上、下呼吸道感染的主要病因之一，占社区获得性肺炎的40%。年幼儿童也会受到影响，近期儿科人群中也有肺外表现的报道。我们对2012年至2020年间入住意大利北部艾米利亚-罗马涅地区最大的三级儿科转诊中心——博洛尼亚圣奥索拉·马尔皮基大学医院儿科急诊科的MP阳性患者进行了回顾性分析。我们确定了145例MP感染患者（82例男性和63例女性），其中27%年龄小于2岁；中位年龄为5岁（四分位间距1 - 9岁）。不同年龄组的临床表现存在部分差异。学龄儿童更易出现胸部X线确诊的肺炎（ = 0.013），而年幼儿童更常需要吸氧治疗（ = 0.048）。74名儿童（51%）出现肺外表现，主要为胃肠道表现（30%）和皮肤表现（14%）。6岁以上儿童神经症状更常见（ = 0.006）。不同年龄组其他肺外表现的发生率无显著差异。本研究表明，MP感染是儿科住院的常见原因，包括2岁以下儿童。临床医生应意识到MP的多种临床表现，包括肺外表现，以实现正确诊断并确定适当的治疗方法。
