Pediatric Mycoplasma pneumoniae pneumonia is diagnosed by examination

Mycoplasma pneumonia often occurs in children, and mycoplasma pneumonia is a common type of pneumonia. This disease is closely related to our lives, and today I will introduce you to Mycoplasma pneumoniae pneumonia in children.

Pediatric Mycoplasma pneumoniae pneumonia is diagnosed by examination

Diagnosis is made based on a combination of clinical symptoms, x-ray findings, and serologic findings. Although the isolation of Mycoplasma pneumoniae by culture is decisive for diagnosis, its detection rate is low, the technical conditions are high, and the time required is long.

Serological tests have a certain reference value, especially if the serum antibody is 4-fold high. This disease should be distinguished from viral pneumonia and Legionella pneumonia. Peripheral blood eosinophil count is normal and can be distinguished from eosinophilic pulmonary infiltrates.

1. X-ray chest X-ray

Pulmonary markings are increased, and the lung parenchyma is mottle, patchy, or uniformly blurred.

2. Etiological examination

Sputum, nasal, and throat swabs for Mycoplasma pneumoniae.

3. Serological examination

The titer of serum pathogenic antibody was >1:32, and the titer of streptococcal MG agglutination test was positive ≥:40, and it was diagnostic for two consecutive increases of more than 4 times.

The total number of peripheral white blood cells is normal or slightly increased, and neutrophils are predominant. Two weeks after the onset of illness, about two-thirds of patients have a positive condensation set test with a titration titer greater than 1:32, especially when the titer is gradually increased, which is diagnostic.

About half of patients have a positive streptococcal MG agglutination test. Further confirmation of the diagnosis depends on the measurement of mycoplasma IgM antibodies in serum (enzyme-linked immunosorbent assay is the most sensitive, immunofluorescence is more specific, and indirect hemagglutination is more practical). Antigen testing can be done by pCR, but kits need to be improved to improve sensitivity and specificity.

Diagnosis of Mycoplasma pneumoniae pneumonia in children

Clinical symptoms such as headache, fatigue, myalgia, nasopharyngeal lesions, cough, chest pain, purulent sputum, and bloody sputum are helpful in the diagnosis by x-ray findings of the lungs and laboratory tests such as condensation tests.

Mycoplasma pneumoniae infection, also known as primary atypical pneumonia or condensation-positive pneumonia, is caused by Mycoplasma pneumoniae, a smaller than bacteria and larger than a virus. MP is one of the important pathogens of pneumonia and other respiratory infections in childhood.

It is more common in older children. The main symptom is cough, which initially manifests as frequent dry cough without sputum, and later secretes sputum. Fever can be mild or severe, with anorexia, headache, sore throat and other symptoms. Most white blood cells are not high. Auscultation of the lungs is not obvious, whereas x-rays may show large opacities and elevated serum cold agglutinins.

1. Incubation period

The incubation period is 2~3 weeks, the onset is slow, and about 1/3 of the cases are asymptomatic. It appears in the form of bronchio-bronchitis, pneumonia, earringitis, etc., and pneumonia is the most severe. At the beginning of the disease, fatigue, headache, sore throat, chills, fever, muscle aches, loss of appetite, nausea, vomiting, etc., the headache is significant.

Fever can vary from high to low and can be as high as 39°C. After 2~3 days, obvious respiratory symptoms appeared, such as paroxysmal irritating cough, coughing up a small amount of mucous or mucopurulent sputum, and sometimes blood in the sputum. Fever can last for 2~3 weeks.Cough with substernal pain but no chest pain may remain after the fever returns to normal.

2. Physical symptoms

Physical examination revealed mild nasal congestion, runny nose, and moderate pharyngeal congestion. The eardrum is often hyperemic, and about 15% have myringitis. Cervical lymph nodes may be enlarged. A few cases have maculopapular rashes, erythema, or cold sores. There are generally no obvious abnormal signs in the chest, dry or wet rales can be heard in about half of the cases, and a small amount of pleural effusion occurs in about 10%~15% of cases.

3. Miscellaneous

The disease is usually mild and sometimes severe, but death is rare. Fever for 3 days to 2 weeks, cough can be prolonged to about 6 weeks. 10% recurred, pneumonia was seen in the same lobe or the same lobe, and a small number of patients had a red blood cell condensation titer of more than 1:500. There may be considerable intravascular hemolysis, which is often seen in defervescence or in cold.