Vol. 24 - Num. 95
aPediatra. CS Valdespartera-Montecanal. Zaragoza. España.
bPediatra. CS Actur Norte. Zaragoza. España.
cCS Canal Imperial. Zaragoza. España.
dPediatra. CS Alfajarín. Zaragoza. España.
ePediatra. CS José Ramon Muñoz Fernández. Zaragoza. España.
Correspondence: M Cemeli. E-mail: email@example.com
Reference of this article: Cemeli Cano M, López Campos M, Oliván Otal P, Navarro Serrano EM, Lostal Gracia MI, García Vera C. Mycoplasma pneumoniae: differential clinical features and diagnostic challenges in atypical pneumonias in children . Rev Pediatr Aten Primaria. 2022;24:273-84.
Published in Internet: 11-10-2022 - Visits: 884
Introduction: pneumonia caused by Mycoplasma pneumoniae continues to be underdiagnosed in paediatric primary care, especially in younger children.
Material and methods: prospective study conducted in 9 primary care paediatric caseloads, including children aged 1 month to 14 years with pneumonia diagnosed based on compatible radiographic findings and clinical features. The aetiological diagnosis was made by acute-phase serological testing. We analysed the association of different variables with atypical and typical aetiologies.
Results: of the 92 patients in the sample, 30.4% had atypical pneumonias which, while not rare in children under 2 years (26%) predominated in children over 5 years (80.9%). The mean age in months was significantly higher in cases with an atypical (74.2±42.2) versus typical (35.9±33.8) aetiology (p<0.0001). Nasal congestion (42.8%; OR 1.8; p<0.01) and tachypnoea (64.2%; OR 2.4; p<0.014) were significantly more frequent in typical pneumonia. The alveolar pattern was observed in 53.6% of atypical pneumonias, with no differences compared to typical pneumonias. Only 25% of atypical pneumonia cases were treated correctly with first-line macrolide monotherapy, with no differences in outcomes based on the choice of antibiotherapy. Patients with typical pneumonia required intravenous antibiotic therapy more frequently (15.6%), but the difference was not statistically significant.
Conclusion: atypical germs were more frequent at younger ages than previously described, in some cases with concomitant detection of viruses. Improving the diagnosis and treatment of atypical pneumonia remains a challenge.
Keywords● Mycoplasma pneumoniae ● Pneumonia ● Primary care
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