Clinical Analysis Of 17 Cases Of Necrotizing Pneumonia With Mycoplasma Pneumoniae Infection In Children

Objectives: To analyze the clinical characteristics of necrotizing pneumonia with Mycoplasma pneumoniae(MP)infection in children.Method: Retrospective analysis was conducted in 17 children with MP necrotizing pneumonia admitted into Children's Hospital of Chongqing Medical University from September 2014 to September 2018.Results: 17 pediatric patients(10 males and 7 females)were enrolled,the average age was [4.9(3.0,7.5)]years.All children were characterized by fever,cough and expectoration.The average thermal spike was(40.0±0.9)?,the duration of fever was(19.2±4.8)days,and the hospital stay was(22.6±15.6)days.Pulmonary auscultation showed a reduction in respiratory sounds in all children.The mean value of peripheral blood leukocytes were(24.3±5.7)×10 9 /L,mean peak neutrophil ratio was(73±18)%,and the mean value of C-reactive protein was(92.1±25.4)mg/L.The mean value of lactic dehydrogenase was(671.2±292.5)U/L,mean valueof fibrinogen was 5.01(3.49,6.26)g/L,and the mean value of D-dimer was 12.2(9.22,14.3)mg/L.8 cases had bacterial positive,including Streptococcus pneumoniae(4 cases),Haemophilus influenzae(2 case),Staphylococcus aureus(1 case)and Klebsiellap neumoniae(1 case)respectively.All patients had pleural effusion.The average duration for chest CT scans showing the low density area,air-containing cysts or small cavities on the basis of lung consolidation was(18.5±4.6)days.Bronchoscopy found massive yellow secretion in 11 cases,bronchostenosis in 3 cases and one lumen partial-obstruction caused by sputum bolt.With the treatment of antibiotics and other comprehensive therapeutic methods,all cases discharged without manifestations.After 6-month follow-up,15 cases recovered completely,one patient had fibrotic streaks.One case was lost during the follow-up.Conclusion: Necrotizing pneumonia with MP infection has persistent high fever,complicated by pleural effusion,companied by CRP?LDH?Fib and D-D increased significantly.While the prognosis is relatively well when treated with comprehensive measure.