최근 유행한 소아 Mycoplasma pneumoniae 폐렴에서 5세미만 입원환자의 임상적 특성

Abstract

Purpose: It was found that clinical features of Mycoplasma pneumoniae (MP) pneumonia of 2011 year epidemic were different from that of 2011 endemic. So clinical findings according to age also could be changed, but there is no study for it. This study is to know its clinical characteristics in children under 5 years old. Methods: I collected the informations of MP pneumonia patients who had been admitted and diagnosed by a serologic method at the Department of Pediatrics, Yongin Severance Hospital, Yongin, Korea from September 2011 to December 2011. I divided the patients to group A (<5 years old) and group B(≥5 years old). I investigated and compared their clinical characteristics. Results: There were 80 cases for group A and 63 cases for group B . Male to female ratios were different between two group( 41/39 for group A versus 28/35 for group B). The frequent symptoms and sign for group A were cough(100.0%), sputum(97.5%), fever(93.8%), and rale(62.5%). Chest radiological infiltration had been found 73 cases(91.2%) for group A and 56 cases(88.9%) for group B. Group A showed more frequent pre-admission fever(93.8% versus 82.5%, P =0.034), cough for 7 and over days(46.3% versus 29.0%, P =0.037), and high serum asparate aminotransferase level(≥40 IU/mL, 30% versus 14.3%, P =0.027), higher titer of antiMycoplasma pneumoniae IgM index(6.4 ± 4.7 versus 4.9 ± 4.3, P = 0.034), higher blood leukocyte count(12,571.3 ± 8,523.3/μL versus 8.152.4 ± 3.165.1/μL, P =0.000007) and platelet count(308,003.8 ± 106,965.6/μL versus 245,377.8 ± 98,985.8/μL, P =0.007) than group B. Group B had more prolonged duration of pre-admission fever(4.7 ± 3.1 days versus 3.6 ± 3.1days, P = 0.029) and a tendency of more frequent rale(79.4 % versus 72.5%, P =0.343), lobar/segmental pneumonia(57.1% versus 45.0%, P =0.149), pyuria(20.6% versus 10.0%, P =0.074) and of less frequency of wheezing(6.8% versus 17.5%, P =0.073) than group A. The other clinical and laboratory findings were not significantly different. The admission durations of group A and B were 4.1 ± 1.6 days and 4.3 ± 1.6 days respectively( P =0.440). Conclusion: During recent epidemic of MP pneumonia, younger children showed severe clinical manifestation more frequently. So physician should keep this finding in mind during caring the young. Continuous monitoring for it should be carried on to know its up-to-date features.