Department of Respiratory Disease, Children's Hospital affiliated to Shandong University, Jinan, 250022, Shandong, China.
Jinan Key Laboratory of Pediatric Respiratory diseases, Jinan Children's Hospital, Jinan, China.
BMC Pediatr. 2024 Jan 16;24(1):52. doi: 10.1186/s12887-023-04512-1.
Mycoplasma pneumoniae (MP) is one of the most common causes of community-acquired pneumonia in children. Most children have fever. In 2021, we found that the proportion of children without fever increased. The aim of this study is to summarize the differences in the clinical characteristics of children with MP pneumonia who are febrile or not, and to raise awareness of children who are not febrile.
Demographic information of the children was collected on admission. Clinical manifestations during the course of the disease and the first laboratory, imaging, and pulmonary function tests before discharge were recorded and compared.
From August to December, a total of 542 people were included in the study. We found that older children were more likely to have fever. Inflammatory indicators including procalcitonin (P = 0.030), C-reaction protein (P < 0.001), erythrocyte sedimentation rate (P < 0.001), ferritin (P = 0.040) and the rate of atelectasis (P = 0.049) of febrile children were higher in febrile children. However, the elevated lactate dehydrogenase and pulmonary function impairment (P all > 0.05), especially the small airway function impairment, are no lower in afebrile children than in febrile children.
The fever rate is lower in younger children, but wheezing is more common. In afebrile children, the impairment of organ and lung function was no less than in febrile children. Therefore, attention should also be paid to children who are not febrile.
肺炎支原体（MP）是儿童社区获得性肺炎的最常见病因之一。大多数儿童有发热。2021 年，我们发现不发热儿童的比例增加。本研究旨在总结发热与不发热儿童 MP 肺炎的临床特征差异，提高对不发热儿童的认识。
入院时收集患儿的一般资料。记录并比较患儿在病程中的临床表现以及出院前首次实验室、影像学和肺功能检查结果。
2021 年 8 月至 12 月共纳入 542 例患儿。我们发现年长儿更易发热。发热患儿的炎症指标如降钙素原（P=0.030）、C 反应蛋白（P<0.001）、红细胞沉降率（P<0.001）、铁蛋白（P=0.040）及肺不张发生率（P=0.049）更高。但不发热患儿的乳酸脱氢酶升高及肺功能损害（均 P>0.05），尤其是小气道功能损害并不低于发热患儿。
不发热患儿中，年长儿发热率较低，但喘息更常见。不发热患儿的器官和肺功能损害并不低于发热患儿，因此也应关注不发热儿童。
