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The Clinical Presentation of Pediatric Mycoplasma pneumoniae Infections—A Single Center Cohort

Gordon, Oren MD, PhD; Oster, Yonatan MD; Michael-Gayego, Ayelet PhD; Marans, Rachel S. MD; Averbuch, Dina MD; Engelhard, Dan MD; Moses, Allon E. MD; Nir-Paz, Ran MD

The Pediatric Infectious Disease Journal: July 2019 - Volume 38 - Issue 7 - p 698–705
doi: 10.1097/INF.0000000000002291
Original Studies
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Background: Mycoplasma pneumoniae (MP) is a major cause of community-acquired upper and lower respiratory infections in school-age children; however, there is increasing recognition that younger children are also affected. Clinical manifestations vary from asymptomatic, to severe complicated pneumonia sometimes with extrapulmonary manifestations.

Methods: We reviewed the medical records of all MP positive pediatric patients admitted to the Hadassah-Hebrew University Medical Center. MP positive case was defined if MP polymerase chain reaction was positive from an oropharyngeal swab sent from 2007 to 2017.

Results: During the study period, we identified 353 MP positive pediatric cases, of which 51.3% (181 of 353) were younger than 6 years old. Full clinical data were available for 332 of 353 (94%). The median age was 5.7 years (range, 3 weeks to 18 years). Disease presentation differed between younger and older children. Children older than 6 years were more likely to have chest radiograph confirmed pneumonia (66% vs. 52%; P = 0.009), while younger children were more likely to have other respiratory manifestations (37% vs. 25%; P = 0.017). The duration of hospitalization and pediatric intensive care unit admission rate, however, did not differ between age groups. The rate of extrapulmonary manifestations were also similar.

Conclusions: MP-associated infection is a significant cause of hospitalization in the pediatric population including younger children (<6 years old). However, the clinical presentation in younger age is less typical than is thought. These findings should prompt clinicians to consider MP infections also in children younger than 6 admitted with fever even without pneumonia.

From the Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Accepted for publication January 13, 2019.

Supported by intramural funds without any external funding.

The authors have no conflicts of interest to disclose.

Presented in part at the 22nd International organization of Mycoplasmology in Portsmouth, NH; July 2018.

Address for correspondence: Oren Gordon, MD, PHD, Department of Pediatrics, Division of Pediatric Infectious Diseases, Johns Hopkins Medicine, David M. Rubenstein Child Health Building, 200 N Wolfe Street, Baltimore, MD 21287. E-mail: ogordon3@jhmi.edu.

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