최근 유행한 소아 Mycoplasma pneumoniae 폐렴의 임상 양상

Abstract

Purpose: Mycoplasma Pneumoniae(MP) pneumonia epidemic has been occurred

in cyclic pattern and it recently observed from September in 2011. There

had been a few studies for it, so this study has been done to know its clinical characteristics in children. 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 January 2011 to December 2011. I compared their clinical characteristics between group A(epidemic period from September to December) and group B(endemic period from January to August). Results: There were 143 cases for group A and 80 cases for group B . The mean ages of group A and B were 4.8 ± 3.2 and 5.3 ± 3.0 years old, respectively(P =0.392). Male to female ratios were not different between two groups(79/64 for group A and 42/38 for group B). The frequent clinical findings for group A were cough(99.3%), sputum(96.5%), fever(88.8%), rale(68.5%), and decreased breathing sound(7.7%). Chest radiographic infiltration had been found in 129 cases(90.2%) of group A and 76 cases(95.0%) of group B. Group A has showed the longer preadmission fever(4.0 ± 3.1 days versus 3.0 ± 2.3 days, P=0.017), more frequent cough(99.3% versus 93.8%, P =0.021) and sputum(96.5% versus 82.5%, P=0.0003), and less vomiting(9.1% versus 18.8%, P =0.017), higher titer of anti-Mycoplasma pneumoniae IgM index(5.7 ± 4.6 versus 3.4 ± 2.3, P =0.000036), less hematuria (4.2% versus 15.0%, P=0.005) and tendency of more frequent and higher elevation of serum alanine aminotransferase(8 cases, 218.0 ± 435.1 IU/mL versus 1 case, 140 IU/mL) than group B. The other features were not significantly different. The admission durations were 4.2 ± 1.6 days for group A and 4.3 ± 1.3 days for group B(P = 0.534). Conclusion: The initial clinical manifestations and titer of anti-Mycoplasma pneumoniae antibody of recent MP pneumonia were more severe and higher in epidemic period than in endemic period. Because its clinical and laboratory features have been changed by epidemic, continuous monitoring and study for it should be carried on.