Clinical diagnosis and treatment of Mycoplasma pneumoniae pneumonia

Mycoplasma pneumoniae pneumonia: Clinical diagnosis, treatment, and chest X-ray analysis. The method of examination by chest radiograph revealed diverse patterns. Approximately 70% of the patients exhibited lobar pneumonia, which was more common in the right lung and lower lung fields, showing large areas of uniform density or cloudy opacities. Many cases involved entire lung segment consolidation, sometimes with visible air bronchograms. Some cases showed multiple lung dot-like flaky opacities, blurred lung markings, or bilateral diffuse reticular shadows intertwined. A few cases may be combined with atelectasis or pleural effusion. In infants, clinical manifestations are not as typical as in older children, often accompanied by wheezing. Among the confirmed cases, although there were only three cases of infants and young children, all were associated with wheezing, and chest radiographs also showed punctate shadows in the lungs, suggesting differences in clinical presentation and X-ray findings between infants and older children. Yang Huici's coverage indicates that Mycoplasma pneumoniae in infants and young children is more commonly associated with shortness of breath, wheezing, and pulmonary rales, with less obvious fever and fewer pulmonary complications, appearing on chest X-rays as bronchial pneumonia. Xin had irritating cough, blood tests similar to normal, and no positive signs in the lungs at diagnosis, thus chest X-rays were promptly used to assist in the diagnosis. For infants, if chest X-rays suggest bronchial pneumonia and improvement after conventional treatment is not obvious, the possibility of mycoplasma pneumonia should be considered. In the treatment of this group of patients, azithromycin was selected and resulted in cure.

Mycoplasma pneumonia (MP) is a self-limiting disease, but the rational use of antibiotics will shorten the course of the disease and reduce the occurrence of complications. Azithromycin covers the four pathogens causing community-acquired pneumonia (CAP), has high tissue concentrations, strong and durable antibacterial effects, and is the first choice for empirical treatment of CAP. During the process of azithromycin application, the majority of children in this group experienced gastrointestinal reactions such as vomiting, abdominal pain, and vascular irritation. One case showed significantly increased transaminase levels, thus while applying azithromycin, it is important to observe adverse reactions in children promptly, provide symptomatic treatment, and monitor changes in transaminase levels after azithromycin application to prevent drug-induced liver injury.

In recent years, reports of pulmonary complications from MP pneumonia have gradually increased. Most pulmonary complications caused by MP pneumonia are related to immune injury, possibly due to some common antigens in other tissues of MP and the lung, causing the body to produce corresponding tissue autoantibodies and form antigen-antibody complexes, leading to extrapulmonary target organ damage. In this group of patients, some patients had significantly increased eosinophil counts and erythrocyte sedimentation rates, suggesting that MP causing target organ damage and immune response have a certain relationship. Among this group of patients, 4 cases had myocardial damage, 2 cases had elevated urinary albumin, and 1 case each had digestive symptoms and neurological symptoms, accounting for about 23% of the total number of cases. There have been reports of MP pneumonia complicated by encephalitis, hemolytic anemia, thrombocytopenic purpura, rash, etc. Therefore, in clinical practice, particular attention should be paid to monitoring and protecting organ function in children with MP pneumonia to prevent and treat complications.